Page 36 - Complementary and Alternative Medicine Treatments in Psychiatry

36 | Complementary and Alternative Medicine Treatments in Psychiatry

The results are evaluated against the steps of the algorithm in
Figure 2-1. Per the Field Manual, “Abnormal findings listed in
the earlier steps of the algorithm more strongly predict the
presence of physical disease than those occurring in later steps
and hence more urgently require a physician’s attention. A
patient who has any positive finding from any step in the
algorithm should be referred for further evaluation to a
physician who specializes in internal medicine or family
medicine.”

Summary
Given the fact that a known percentage of psychiatrists’ clients
come to them because of undiscovered and/or untreated medical
problems, it is an irony that, of all medical specialists, the
psychiatrist is among those commonly called upon the least to
exercise clinical medical diagnostic skills. The challenge of
mastering differential diagnosis in psychiatry requires, in truth,
a Holmesian eye for signs and symptoms and an equal intellect
for hazarding the maze of possible risk factors.
Absent this cautious approach, much suffering can occur. Seen
from the eyes of a patient or his or her family, the slow or
sudden decline into psychosis, deep depression, unrelenting
obsessive thought or other severe psychiatric symptoms can be a
nightmare. While a patient or physician may be anxious to
assign a psychiatric diagnosis to the syndrome presented, a
failure to look for and detect a possibly underlying medical cause
or contributing factor could unnecessarily prevent the
alleviation of, extend, or deepen this world of doom the patient
endures.
Properly examined, diagnosed, and treated, the client with a
hidden medical illness may have the good fortune of being
rescued from the dustbin of “nonresponsive to treatment” and
find hope and relief under the watchful eye of his physician.