The diagnosis of mental illness Mental illness - ashamed to ask for help?   easy to install, it usually occurs during a sufficiently long observation of the patient in the hospital. Additional methods of research in psychiatry do not have as much value as in other branches of medicine. Therefore, as an aid to diagnosis using various psychological tests.

Theoretical Foundations of testing in psychiatry

Psychological tests, which are used in psychiatry - a standardized task, the result of which is a measure certain mental and personality characteristics of the patient, as well as to assess their knowledge and skills. These tests must meet the following requirements:

• Standard - permanence of jobs and the conditions of its implementation;
• objectivity - that is, to minimize the possibility for the investigated purposefully influence the results of the study;
• Reliability - it is defined by a high degree of similarity between the results of repeated measurements on one and the same subject without changing its state.

Theoretical basis of the test have been developed in English psychologist Hamilton at the end of the 19th century. Currently, psychiatry is used a lot of tests that allow a better understanding of the patient's personality, his intellectual abilities and attitude to the world. The tests often help to reveal hidden forms of mental illness, the risk of acute illness, suicide attempts and aggression, various types of simulation and so on.

Types of psychological tests used in psychiatry

Psychological tests used in psychiatry, divided into test efficiency and personality tests. Tests of efficiency (productivity) allow us to estimate the intellectual activities (thinking, memory, attention), general and special abilities.

Personality tests are in turn divided into subjective, projective and objective. Subjective personality tests include the scale of self-esteem, attitudes and interests. When projective personality test under study presented indeterminate material that it should logically complement and interpret. Objective tests are tests by which to assess the real actions of the subject.

Tests are also divided into individual and group, allow to allocate the last people who need a deeper examination. There are verbal tests (they require a verbal response) and nonverbal (tasks for manipulation, for example, folding integral figure of the individual parts), written, oral and hardware.

Tests on efficiency

The most commonly used test is the test of intellectual Wechsler, which is a collection of 11 classic techniques combined into one based on a special statistical processing of the results of each method. Of these 6 tasks of verbal and non-verbal 5.

Answers are evaluated according to the established scale. The number of points received in all tasks through the appropriate translation tables in IQ (IQ). Wechsler test reveals not only intelligence, but also allows you to assess the degree of intellectual disability and mental retardation Mental retardation - if the mind is underdeveloped Ie mental retardation.

The tests of general ability to identify and account ownership of speech, the accuracy of perception, the ability to highlight important details in the speech, responsiveness and so on. Tests of special abilities today are organized on the computer, it automatically allows you to evaluate not only the correct answer, but the time of their execution.

Personality Tests

Among the subjective personality tests in the psychiatric practice, the most common scale Beck and Zung. They allow you to track, for example, change the signs of depression Depression - a little more than a bad mood   under the influence of treatment.

From the most common personality questionnaires Minnesota Multiphase Personality Inventory (MMPI). It consists of 550 cards with statements. Depending on the attitude to them ("correct", "incorrect", "do not know") lays out the test cards into three groups. Processing of the results gives the profile, which is then interpreted. The test reveals aggravation (exaggerated painful disorders), dissimulation (concealing evidence of disease) and the desire to show themselves in the best light. Additional scales allow the use of MMPI questionnaire for the narrower purpose of identifying specific symptoms. All personality tests have special options for the study of children. The original patoharakterologicheskie Diagnostic Questionnaire (PDO) for the detection of abnormalities of personality in adolescents was developed AE Licko.

From projective personality tests most famous is the Rorschach (inkblot test), based on an analysis of the perception of meaningless test standard stains. This test is used to detect a variety of mental disorders, determining the risk of suicide and aggression.

An example of objective personality tests are tests for conformity, that is, the degree of stability of opinions, preferences and behavior of the test group with the pressure of a front group of 7-9 people, which acts on the pre-approved plan.

As psychiatric examination conducted by means of tests

The most effective is the use of the battery (test suite), compiled in accordance with the objectives of the study. For example, to confirm the diagnosis of schizophrenia Schizophrenia - to blame civilization   It is considered the most effective battery consisting of Rorschach, MMPI and other tests. Such a battery is complemented by the use of other techniques (for example, the classification of objects and other), as well as data of clinical examination of the patient.

Galina Romanenko

Borderline personality disorder - a severe mental illness Mental illness - ashamed to ask for help? , Which is characterized by unstable mood, behavior and relationships. Most people with borderline personality disorder suffer from problems with control over emotions and thoughts, impulsive and irresponsible behavior, unstable relationships with others. In these patients, there is a high probability of comorbidities, such as depression, anxiety disorder, dependence on alcohol or drugs, eating disorders, and so on.

Borderline personality disorder is quite common, although the Guide to Diagnostic and Statistical Manual of mental disorders was included only in the 1980's. Because many people with this disorder case of brief psychotic episodes before experts believed the disease or atypical frontier kind of other psychiatric disorders. Later, borderline personality disorder has been allocated as a separate violation of many experts do not agree with this name, but the more accurate term is not found.

Causes

Studies on the possible causes of borderline personality disorder, are still in the initial stages. However, scientists agree that contribute to the development of disorders can both genetic and various environmental factors. Studies of twins suffering from borderline personality disorder have shown that the disease is largely due to heredity. In another study it was found that a person may inherit a certain temperament and personality traits such as impulsivity or aggression. Now scientists are engaged in research of genes that help regulate emotions and control their own impulses - it is possible that they are associated with borderline personality disorder.

Social or cultural factors may increase the risk of developing this disorder. For example, if a person belongs to a community or culture in which unstable family relationships are common, the likelihood that he will develop borderline personality disorder significantly increased.

Symptoms

Borderline personality disorder is diagnosed when a person has been persistent pattern of behavior, which includes at least five of the following symptoms:

• Tendency to very strong reactions in the fear of being alone (regardless of whether or not this fear is good reason) - such reactions are anger, panic, depression, various rash acts;
• Unstable and strained relations with family, friends, partners - they can range from very close to the equally extreme rejection;
• Distorted perceptions and unstable itself, which can lead to sudden and drastic changes in opinions, values, emotions, and goals and plans for the future;
• Impulsive and often dangerous behavior - such as drug use, unprotected sex, careless driving, overeating;
• Regular threat or attempt to commit suicide Suicide in terms of the psychiatrist - can it be prevented? Or self-injurious behavior;
• Very changeable mood extremely strong emotions, and each episode lasts from a few hours to several days;
• Chronic feelings of emptiness and / or boredom;
• Strong anger, not corresponding to the situation or problems controlling anger;
• Related Stress How to beat stress? Create an oasis   paranoid thoughts or severe dissociative symptoms such as a feeling of isolation, separation from yourself, seeing yourself from or loss of touch with reality.

Triggers these symptoms can become quite ordinary event. For example, a person suffering from borderline personality disorder can become angry because of such minor things as a trip partner in a business trip or a vacation, or a sudden change in his plans. Studies show that people with this disorder can see the anger in an emotionally neutral facial expression, and speech with a negative value, they react much more than people who do not suffer from this disorder.

Usually the first symptoms of borderline personality disorder occur in adolescents and young adults, but in some cases it occurs in early childhood.

Diagnostics

Unfortunately, borderline personality disorder often goes undiagnosed or misdiagnosed. This is due both to the fact that the symptoms are not always strongly expressed and due to the fact that they are often mistaken for signs of other disorders. Diagnosis is often difficult and the presence of comorbid psychiatric disorders. According to experts, about 85% of symptoms in humans suffering from borderline personality disorder meet diagnostic criteria for other disorders.

To diagnose borderline personality disorder, the doctor needs to examine how the personal and family history of the patient and to hold a conversation with him (often - not one) - this allows a more or less complete picture of the disease, and to correctly interpret the symptoms. The diagnostic process usually takes a long time, and the disease often reveals not the first doctor to whom refers the patient.

Treatment

Previously it was thought that borderline personality disorder is very difficult to treat, but recent studies have shown that in many cases the therapy gives good results: the improvement is not too fast, but stable.

For the treatment of patients with borderline personality disorder is commonly used therapy. Following remission, some symptoms may appear from time to time again, but the real relapses with the full manifestation of the symptoms are very rare.

Sometimes, in addition to psychotherapy, drug therapy is used - it helps ease the symptoms of the disease such as anxiety Anxiety - how to distinguish normal from disease? , Depression and aggression. Patients often take several drugs at the same time, however, it is unclear whether such treatment is necessary and effective.