How is examination by a psychiatrist carried out and to whom is it indicated?

How long does it take a competent psychiatrist to make a diagnosis? Should a doctor be nice to you and how can you understand after one session that it’s time to look for another specialist? This was explained by psychiatrist and creator of the Pinel Case project, Viktor Lebedev, during the first festival of people with mental disabilities in St. Petersburg. Sobaka.ru recorded the main points.

If you think that psychiatrists are magicians who will tell you your diagnosis after the first meeting, then you are mistaken. Sometimes the diagnostic process can take one to two months. Medical diagnosis itself is difficult, and diagnosing mental illness is doubly difficult. In fact, at first the doctor himself may not understand what is happening to you; you need to take this calmly.

There are two types of patients - one is very important to know what mental disorder they have. Others, on the contrary, avoid this information.

Many doctors are guided by the rule: if the person himself does not ask what exactly he is sick with, then you should not force this information into him. “You have recurrent depressive disorder, a moderate episode,” not everyone needs to hear this.

However, the doctor has no right to hide what mental disorder you suffer from if you ask him for this information.

Your doctor does not have to be a sympathetic and pleasant person in every way. He heals you, but he is not your friend. Usually 30-40 minutes are allotted for an appointment with a psychiatrist, and this is not always enough to get into close contact with the patient and get into him.

And you shouldn’t expect that after talking with a psychiatrist you will immediately feel better. Unfortunately, it doesn't always work out that way.

Don't be afraid to ask questions, they should answer you. And if you do not ask them, then do not be offended that you receive little information about your condition and the treatment process. The patient's activity stimulates the psychiatrist to work more thoughtfully.

No one has the right to prevent you from recording an appointment, and you don’t even have to tell your psychiatrist about it. In theory, this works like monitoring a medical service. The recording can be useful if you need to re-listen to something or remember your doctor’s recommendations.

You can make notes in a notebook during the session and come with questions already formed. Take notes if you get lost in front of a doctor at an appointment. In addition, you can take a partner, relative or even a friend with you to the session.

In general, anyone, even your lawyer. 

If you come and tell the doctor: I read everything on the Internet and realized that I have bipolar affective disorder, then most likely this will cause outright resistance from the specialist. Self-diagnosis is often the wrong method of studying oneself and should not be abused. Often, out of hundreds of people who complain of panic attacks, only a few actually experience them.

Mental health care is provided without a religious component—and this is an important ethical issue. If a doctor tells you: “Go to church, pray and you will feel better,” then run away from him. At the same time, psychiatrists come across different patients: with some religion is not discussed at all, while there are very church-going people. It is important not to offend any of them.  

“This is all because you didn’t give birth to a third child,” after hearing such an argument from a psychiatrist, you should also think about looking for another specialist.

Doctors should not explain things that happen in a patient's life to the level of the neighbors down the stairwell. On the part of the doctor, only a professional point of view should be heard, and even everyday issues should be conveyed in professional language.

The doctor cannot tell you: “Well, no, you were just making up some nonsense for yourself, relax.”

Think about it, if you call a doctor to arrange a visit, and the answer is: “Hello, the best psychiatrist in St. Petersburg is listening to you.”

A doctor should not try to convey to everyone how great he is and how effectively he treats everyone.

Among truly professional specialists, there is an understanding that therapy is a complex process, and despite having qualifications, a doctor cannot always help every patient.

Unfortunately, situations where doctors start relationships with patients and continue to treat them do occur. This is a gross violation of ethics. If the doctor gives you ambiguous hints, immediately change the specialist, because this can go very far. A psychiatrist cannot treat friends either. If you drink at a bar in the evening and come to a reception in the morning, this is unprofessional.  

When you pay a person for a private appointment, it's one conversation. But when the psychiatrist you come to for free sessions hints at monetary incentives for his services, this is already a serious violation of ethics. If you yourself want to thank a specialist, this is already a difficult question. Some take the money, others refuse such thanks on principle.  

Based on materials from Victor Lebedev’s lecture “How to prepare for a visit to a psychiatrist and recognize an ethical specialist?” within the framework of Psychogorfest.

Source: http://www.sobaka.ru/health/health/79000

Examination by a psychiatrist to obtain a driver's license

Very often, Russian residents’ familiarity with psychiatry is limited only to an examination by a psychiatrist when obtaining a driver’s license.

Despite this, going to a psychoneurological clinic to get the required mark can become a serious moral test and raise a lot of questions. In this text we will tell you how to undergo an examination by a psychiatrist to obtain a driver’s license.

We will also explain for what reasons a psychiatrist may refuse permission to drive a car or motorcycle.

2015 N 344n “On conducting compulsory medical examination of vehicle drivers...”. The second is the decree of the Government of the Russian Federation of December 29, 2014.

N 1604 “On lists of medical contraindications, medical indications and medical restrictions on driving a vehicle.” All the main provisions regarding examinations by a psychiatrist are described in them.

It is important to understand that not every medical organization that has a psychiatrist on staff has the right to conduct examinations to obtain a driver’s license. The law describes it as follows:

“An examination by a psychiatrist is carried out in specialized medical organizations of the state or municipal health care system at the place of residence or place of stay of the driver of the vehicle (candidate driver of the vehicle) undergoing a medical examination (hereinafter referred to as the examinee), who have a license to carry out medical activities to provide services. (performance of work) in “psychiatry” and “psychiatric examination”.

Specialized medical organizations here mean dispensaries, dispensary departments or regional psychiatric offices in central district hospitals. Private medical organizations can carry out such examination in two ways. The first way: they can invite a psychiatrist from a local government agency to the clinic.

As a rule, a list of people who have already signed up for the driver’s commission is sent to this institution in advance. They are checked against the dispensary's database, and if necessary, a card is raised for someone who previously contacted the dispensary in order to make a decision in his case.

The second way: they obtain a license for a psychiatric examination and conduct it on their own.

The following must be examined by a psychiatrist:

• candidates for vehicle drivers (driving school students, in simple terms);
• drivers whose license has expired;
• drivers who have had their driving license revoked after their return;
• people who were prohibited from holding certain positions or engaging in certain types of activities (if at the same time they were deprived of their driver’s license).

Examination by a psychiatrist in public and private organizations is carried out at the expense of the person being examined. This should also be kept in mind when going through this procedure.

Now about the examination itself. There is not a word in the law about how this should happen: it depends on the traditions of the institution itself and the personal approach of the psychiatrist.

You can meet a meticulous specialist, or you can meet a doctor who will ask a couple of routine questions, stamp it, write “pass” and send it on.

In addition, the law does not stipulate that in order to be examined by a psychiatrist you need any other documents other than a passport.

Very often you can hear that for a psychiatric examination to obtain a license you need a military ID, a registration certificate and a certificate from your previous place of residence, but they are not mentioned .

The Ministry of Health of the Russian Federation does not believe that they are needed for a psychiatric examination. For this reason, you don't have to show them if you don't want to or if you don't have them with you. If a psychiatrist or medical receptionist refuses to examine you on this basis, then they are breaking the law, and you have a real reason to talk to the management of the clinic or to file a complaint. The mandatory requirement for a military ID becomes strange when it comes to girls and women, who rarely ever have one.

If a person is mentally healthy and has never consulted a psychiatrist, then usually there are no difficulties when communicating with a psychiatrist.

In the case where the result of treatment is a diagnosis of “Mentally healthy” or “Recovery,” the person is usually not sent for additional examinations.

Let’s say the situation is like this: a person applied, but during the observation period he was not recognized as healthy (i.e., there is no entry in the card “mentally healthy”, “recovery”). Usually a psychiatrist interviews him and refers him to a medical psychiatric commission.

Sometimes, before the commission, a person may be prescribed a psychological examination to clarify the diagnostic idea. In this case, the law does not specify any other requirements for examination.

The same mechanism works for those who have questions in private medical organizations: they are sent to a local psychoneurological dispensary.

The Decree of the Government of the Russian Federation has developed a list of psychiatric contraindications for driving transport. It is presented in the table below.

Organic, including symptomatic, mental disorders	F00 - F09
Schizophrenia, schizotypal and delusional disorders	F20 - F29
Mood disorders (affective disorders)	F30 - F39
Neurotic, stress-related and somatoform disorders	F40 - F48
Personality and behavior disorders in adulthood	F60 - F69
Mental retardation	F70 - F79

Let’s clarify right away: these contraindications work when we are talking about chronic and protracted mental disorders with severe, persistent or often exacerbating painful manifestations. Potentially, even with a diagnosis of schizophrenia or bipolar disorder, you can drive a car.

Please also note that even if you were once excluded from military service due to mental health problems, this does not necessarily restrict you from driving a car.

An inspection at the military registration and enlistment office and its result is not the same as an inspection for driving a vehicle, especially since it is not necessary to present a military ID.

One last detail: if you are banned from driving due to a mental condition, it is not permanent. You may be restricted for a maximum of 5 years, and you retain the right to be re-examined. If you do not agree with the decision of the medical commission on your restriction, then you have the opportunity to challenge it in court.

Source: http://delopinelya.ru/2019/01/31/osmotr-dlya-polucheniya-prav/

Examination and consultation with a psychiatrist in Moscow - prices for a medical examination in the clinic

An examination by a psychiatrist and a narcologist is often necessary when applying for a job, obtaining a driver’s license or permission to store and use weapons. At the Yusupov Hospital, patients can be examined by a psychiatrist anonymously. Doctors guarantee complete confidentiality. The medical staff treats patients with care and respect.

An examination by a psychiatrist and a psychiatrist-narcologist is necessary for people who have mental health problems. In this case, if the patient’s condition does not threaten him or others, psychiatrists consult only with the patient’s consent. The Yusupov Hospital employs professors and doctors of the highest category.

They have higher medical education and specialization in psychiatry, constantly take advanced training courses, and do internships in leading domestic and foreign psychiatric clinics.

Doctors take an individual approach to choosing a diagnostic and treatment program for each patient, use the most effective drugs registered in the Russian Federation and innovative psychotherapeutic techniques, including cognitive behavioral therapy.

Questions from a psychiatrist during a medical examination

The task of a psychiatrist is to assess the state of a person’s mental health. Often a psychiatric examination is necessary for persons who will work with people or with complex mechanisms.

A psychiatrist can recognize a person with mental disorders during questioning.

The psychiatrist's questions sometimes seem ridiculous, but the doctor uses a survey to determine whether the patient has a mental disorder.

Then the psychiatrist may ask how relatives differ from family members, how a tram differs from an electric train, or suggest finding similarities between different objects.

The main task of the specialist is to determine whether the person being examined has mental health problems, because the driver must have a good reaction and be able to navigate complex situations.

Before issuing a medical report to a person who wishes to purchase a weapon, a psychiatrist must make sure that the patient has no impaired mental functions. He often asks tricky, strange, seemingly illogical questions:

• What is the difference, father's brother or brother's father;
• How many toes are there on one and the other foot?
• Which is heavier, one kilogram of hay or a kilogram of metal;
• How do hedgehogs reproduce?

The psychiatrist’s appointment time is limited, so if the questions posed are adequately answered, he may not conduct further questioning. But if the doctor deems it necessary, he can continue the conversation. The psychiatrist is interested in the patient's reaction to the questions posed. Often during a psychiatric examination, tests from a psychiatrist are used. With their help, mental disorders are identified.

During an examination of a patient, you may answer incorrectly, but you should not worry or be rude to the doctor. Questions should be answered as simply as possible, without being afraid to think out loud or give reasons. To obtain the necessary information, it is better to behave appropriately.

What questions does the therapist ask?

During the initial examination, the psychotherapist most often asks 3 questions that help to more clearly formulate the task and understand what “baggage”, fantasies, expectations, “starting situation” the patient came with:

• Why did you decide to see a psychotherapist now?
• Why choose this specialist?
• How did you try to solve the problem before?

The psychotherapist is trying to find out what has changed in the situation that the person has decided to seek professional help. Typically, patients give one of the answers to this question:

• “Our” methods do not work;
• Reached the point of powerlessness, despair;
• I want to solve the problem without falling apart from the heavy burden;
• There was a disposition of forces, the situation in the family changed;
• There is an internal need to change your life;
• Advice from friends, acquaintances, relatives, recommendations in books and the Internet do not help and cause irritation.

The vast majority of people do not go to a random psychologist. Patients choose a specific specialist because he meets their requirements, has good recommendations, and the cost of his services is not high. Friends often recommend a psychologist because he knows how to listen, has a sense of humor, and is friendly.

The question “How did you cope before going to a psychotherapist” is very important. Even the smartest, best advice from a specialist will never replace the patient’s experience. He, and not the psychotherapist, will have to act in the future to solve his own life problem. During the first conversation with the patient, the patient tries to understand what experience he has in solving his own problems and what he does with it:

• Considers it as the only possible option;
• Depreciates;
• Convinced of inefficiency and wants a better solution.

After the examination, psychotherapists at the Yusupov Hospital develop an individual treatment program for each patient.

Testing by a psychiatrist

A psychiatrist determines mental dysfunction using tests. The final diagnosis is never based on the results of any, even the most well-known objective testing. Tests allow us to identify a person’s predisposition to a particular mental disorder.

Most often, psychiatrists use the following test formats:

• Questionnaire;
• Exercise;
• Projective tests.

The questionnaire is a regular questionnaire. Questions have multiple answer options. They may be limited to simple confirmations or denials on the part of the patient. Based on the results of the answers, the doctor judges the person’s psychological health.

In tasks, the patient is asked to perform a certain type of action. The psychiatrist draws conclusions by analyzing the results of the completed task. Projective tests are used less frequently in psychiatry.

The patient is placed in an artificially created critical situation. He is offered to find a way out of it on his own, without hints or tips.

There are many tests to identify various mental characteristics.

The most well-known tests are those that psychiatrists and psychotherapists most often use in their work:

• Luscher color test;
• Eysenck method;
• Rorschach inkblot test;
• Szondi portrait test.

Using the Luscher color test, mental abnormalities are identified in pictures, since a person’s color perception can measure his psychological state. The test helps to conduct a quick and detailed personality analysis according to five criteria:

• Desired goals of the individual;
• The current state of affairs;
• Contained qualities;
• Feelings that bring anxiety;
• Current problems.

The doctor offers the subject 8 colors. Of these, the patient must choose the most pleasant one. This test continues until one color remains. At the end of the test, the patient is offered to undergo diagnostics again.

Testing is carried out in natural light, but cards with flowers should not be exposed to direct sunlight.

Also, before starting the diagnosis, the doctor asks the person being tested to proceed solely from personal preferences, not to take into account personal associations, fashion trends and generally accepted social tastes.

Despite the fact that Eysenck's methodology is not designed to identify mental disorders, but to determine the type of temperament, this test is often used by psychiatrists. They believe that based on knowledge about an individual’s predisposition to a particular type of temperament, one can judge the possibilities of the manifestation of mental disorders.

The Eysenck test is a questionnaire. The test results look like a column with temperament types, in which the most suitable one is highlighted. A text transcript is also included with the study.

Below the table provides data on the level of neuroticism (a person’s personality trait, which manifests itself in anxiety, restlessness and emotional instability), extraversion (the subject’s consciousness and attention are focused primarily on what is happening around him).

Based on the test scores, psychiatrists calculate the patient’s predisposition to various mental disorders. Hysterical manifestations are most often observed in extroverts with a high level of neuroticism, and introverts with the same neurotic data may be susceptible to obsessions and neuroses.

Psychiatrists use the Chaplin mask test to identify a person’s schizoid predisposition. It helps in identifying schizophrenia. Chaplin's Mask is an optical illusion test. For two minutes, the doctor asks the subject to look at a Charlie Chaplin mask that rotates in a circle. If it seemed strange to the patient, then this indicates a healthy psyche.

The thinking of a person with schizophrenia is structured somewhat differently than that of a healthy person, so it is not easy to deceive him with such a test.

People who have schizoid manifestations do not succumb to optical illusions, no matter what level of complexity they are. They see Chaplin's mask as concave.

The Szondi test is based on human selectivity regarding one's social environment.

8 portraits are laid out in front of the person being tested and they are asked to alternately exclude the most pleasant ones and those that they like the least. Each portrait reflects one of the psychological drives of a person.

The test results are assessed using a table that indicates the level of predisposition to each of the eight drives that indicate mental disorders:

• S (masochism or sadism);
• H (sexual attraction);
• Hy (tendency to hysterical manifestations);
• K (catatonic tendencies);
• D (tendency to depression);
• P (paranoid manifestations);
• E (epileptoid predisposition);
• M (manic).

The doctor then conducts a detailed textual transcript of the data obtained from the test. This testing option is widely used by psychologists and psychiatrists.

Since the Szondi test helps not only to identify mental disorders, but also to form a holistic picture of a person, this testing is also used in pedagogy, when hiring, or in the work of law enforcement agencies.

The Rorschach inkblot test is used to study the psyche, personal qualities of a person, and identify possible deviations. It is presented in the form of cards with drawings that look more like blots. The test taker is asked to give his own interpretation of what is shown on the card.

Half of the test pictures are presented in black and white, the second half has multi-colored images. Images in the test are evaluated according to certain criteria:

• Integrity;
• Dynamism;
• Brightness of the image;
• Overall clarity of the picture.

The Rorschach Blot test is widely used by domestic and foreign psychiatrists. Tests for mental disorders are useful in the preliminary diagnosis of a particular disorder, but psychiatrists never blindly trust their results. The testing method suggests what in the patient’s character, behavior, and psycho-emotional background one should pay more careful attention to.

How to get an appointment with a psychiatrist? Call the Yusupov Hospital any day of the week, regardless of time of day. Contact center specialists will discuss with you and select a convenient time. You can also consult a psychotherapist.

• ICD-10 (International Classification of Diseases)
• Yusupov Hospital
• World Health Organization. F4 Neurotic, stress-related, and somatoform disorders // International Classification of Diseases (10th revision). Class V: Mental and behavioral disorders (F00-F99) (adapted for use in the Russian Federation). - Rostov-on-Don: Phoenix, 1999. - P. 175-176. — ISBN 5-86727-005-8.
• Shear MK, Brown TA, Barlow DH, Money R, Sholomskas DE, Woods SW, Gorman JM, Papp LA. Multicenter collaborative Panic Disorder Severity Scale. American Journal of Psychiatry 1997;154:1571-1575 PMID 9356566.

Source: https://yusupovs.com/articles/funktsionalnye-rasstroystva/kak-prokhodit-priyem-u-psikhiatra/

If you are due to be examined by a psychiatrist

A psychiatrist is a specialist who diagnoses, monitors and treats mental disorders.

However, an examination by a psychiatrist may also be required for an absolutely healthy person - for example, when obtaining or renewing a driver’s license, obtaining a license to own a weapon, when hiring for certain positions, preliminary and periodic examinations are required by representatives of a number of professions.  

How does an appointment with a psychiatrist go? What will they ask you? How does the doctor assess your psycho-emotional state? In what cases do we, without knowing it, hinder the doctor’s work and complicate the process of obtaining a certificate?

How does an appointment with a psychiatrist go?

As a rule, a clinical interview is sufficient for examination.

This is a dialogue with a doctor, which takes place individually, in a calm, supportive environment. The main goal of the conversation is to assess the patient’s emotional state, identify possible psychopathology, which may become a contraindication to certain opportunities (driving a vehicle, carrying a weapon, working in a particular field, etc.)

The conversation takes on average up to 15 minutes and is carried out only with the consent of the person being examined.

You may be asked a variety of questions. To a person who has never seen a psychiatrist before, they may seem ridiculous - but you can be sure that these are the questions that will allow the specialist to assess your psycho-emotional state.

The psychiatrist is only interested in your psycho-emotional state.

The doctor must understand how socialized you are, how high your anxiety level is, whether your work, communication with people brings you pleasure, etc.

To do this, he can ask a question about where and who you work for - and he expects to hear an answer not about your level of income, but about how you feel, whether you cope with stress, etc.

We strictly adhere to the principle of medical confidentiality and never transfer information about patients to the tax service or other authorities.

How to prepare for your appointment?

An examination by a psychiatrist does not require any special preparation. You should not take any sedatives or other medications: slight anxiety on the eve of the examination is quite natural.

Be open to dialogue.

The conversation will go quickly and constructively if you are ready to communicate, answer questions, behave correctly and politely - even if you are in a bad mood or worried about something.

Try not to refuse to talk. Silence in response to a question is an inadequate response. If a question surprises you or you do not fully understand it, it is best to clarify the question rather than withdraw into silence.

In what cases may I need a more detailed examination?

We talk about a detailed examination if during the conversation the psychiatrist reveals some alarming symptoms. To clarify the patient’s condition, the doctor will ask him to take a short psychological test aimed at identifying personality traits.

When taking the test, you must strictly follow the doctor's instructions. Based on the results of testing, a psychiatrist, as a rule, can accurately indicate the presence or absence of psychopathologies that are contraindications for certain types of activities.

In some cases, the patient is referred for additional examination to a medical psychologist - a specialist who will conduct a pathopsychological examination to identify mental disorders.

The maximum delay period for a decision is 20 days.

On what basis does a psychiatrist decide on contraindications for driving a vehicle, owning a weapon, etc.?

All psychiatrists act according to clear regulations prescribed in regulatory documents.

The list of medical contraindications and restrictions for driving vehicles is prescribed in Decree of the Government of the Russian Federation No. 1604 of December 29, 2014.

Source: http://navigator.mosgorzdrav.ru/columns/psikhiatriya/esli_vam_predstoit_proyti_osmotr_psikhiatra/

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How to see a psychiatrist and get a certificate for an adult or child

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Medical commissions often require you to visit a psychiatrist. This is a mandatory examination for adults to prove their ability to work and mental health. The procedure is prescribed even when applying for a job; it is simpler than it is perceived. Most people get through it without problems.

What does a psychiatrist check?

This doctor looks at the patient for the presence or absence of mental abnormalities and disorders, determines the cause and level of brain disorders. He conducts examinations, makes diagnoses and prescribes treatment, and oversees the rehabilitation of patients. There is a psychiatrist in any clinic; he is part of the medical commissions that determine a person’s disability.

He is also required to be present during forced inspection of those suspected of a crime.

During the examination, a psychiatrist may identify the following problems:

• Autism is a disorder of the process of adaptation in society.
• Depression - severe forms lead to suicide attempts.
• Neurosis – occurs with prolonged psycho-emotional stress and can lead to malfunctions of internal organs.
• Anxiety disorder – often due to chronic stress.
• Schizophrenia is a thinking disorder that manifests itself in speech problems, hallucinations, and delusions.
• Personality disorder is dangerous due to psychosis, severe depression, and aggression.

Why see a psychiatrist?

An examination by this specialist is mandatory for people who are involved in dangerous work, service, or are involved in society (doctors, educators). You will also have to undergo a psychiatrist for a license or permit to carry a weapon, because this has an impact on the life of the person himself and those around him.

Screening is required for children going to school.

Other people don't need it. The procedure is carried out on a paid basis.

Obtaining permission to carry weapons

A psychiatrist, as part of a commission including a therapist, an ophthalmologist and a narcologist, must confirm that a person will not harm himself or others with such a dangerous object. To do this, they check the mental state for a tendency to aggression, depression, mood swings, and personality disorders.

It is important that the person has not previously been registered for these problems.

If everything is in order, a positive conclusion is issued. The certificate is valid for six months.

Obtaining a driver's license

In order for a person to be allowed to drive a car, he must be mentally stable, otherwise he may harm the health and lives of others.

The driver must undergo a commission that includes a psychiatrist. He checks the degree of adequacy of the individual, mental deviations. Even depression can cause a license to be denied.

Then the person undergoes treatment and goes back to the medical examination.

After receiving the certificate, the inspection is carried out again every 1-3 years.

People whose activities require increased concentration, control of dangerous, complex mechanisms, and are associated with responsibility for the lives of others are examined by a psychiatrist (as part of a medical examination). During the examination, the doctor tries to identify mental instability, chronic disorders that may interfere with the performance of these tasks.

If there are deviations, the person will receive a work ban and a treatment plan.

This is required for the following specialties:

• drivers, pilots;
• builders;
• military;
• scientists, doctors;
• teachers.

Admission of a child to kindergarten or school

This examination is as mandatory as other examinations by doctors. Before moving to a new educational institution, a psychiatrist checks the child’s level of development and psycho-emotional readiness.

It is important to see the ability to communicate, express emotions, thoughts, and detect deviations in behavior in time.

Many problems can be identified already at the age of 3-5 years, and starting to work with them so early is easier than at 10-14.

In case of serious deviations, they are given a referral to a special school.

The procedure is available at the state dispensary at the place of registration. It is important that the institution has a license. For a preventive examination, you can get to a psychiatrist simply by making an appointment through the registry or visiting a private center.

According to indications, a referral is given by a neurologist, pediatrician, or family doctor. If you need to get a certificate and undergo a medical examination, you will have to start with a therapist.

Procedure steps:

1. Get a bypass sheet from the registration office of the district clinic.
2. Visit a therapist, take a referral to a psychiatrist, narcologist (not relevant for children’s examinations).
3. Get a report from a narcologist.
4. Come to the psychoneurological clinic for examination.

How is the appointment going?

The state has not established a single approved approach to conducting an inspection, so there is no universal inspection scheme. The doctor can use several methods, combine them with each other, choosing depending on the purpose of the appointment and the patient’s condition. So, for driving a vehicle it is important to test the ability to concentrate, for working in a hospital - the ability to make decisions and take responsibility.

The conversation lasts up to 15 minutes.

Recommendations:

• Don't be silent, don't lower your eyes. If a question is unclear, ask for repetition or clarification.
• Be calm and open to dialogue.
• Answer a clearly stated question, avoid inappropriate jokes.

Survey

The examination by a psychiatrist often begins in a standard way: the doctor finds out the first and last name, basic information about the patient - education, place of birth, family, work. Then he can ask questions, the answers to which seem obvious: day of the week, time of year, day, location (city, country). It is important to answer calmly and not try to understand why they are asking this.

The doctor evaluates coherence of thoughts, logic, clarity of speech, ability to respond, and not knowledge.

If a person has already been to a psychiatrist or has problems, questions related to the diagnosis will arise:

• Do you often suffer from insomnia?
• Do you have any fears?
• What are your relationships like with loved ones?
• Do you have thoughts that are unusual for you?

Provocative questions are not excluded:

• Have you ever had suicidal thoughts?
• Were you not registered?
• How often do you become aggressive?

A standard set of clarifying questions about the condition is often enough to make a conclusion and issue a certificate.

If a psychiatrist sees deviations or wants to clarify something, he may suggest starting to talk about himself and, in the middle of the patient’s monologue, ask him something off topic. "Where do penguins live?" or “What color is the sun?”

Questions may arise that seem unrelated to the person’s mental state: “What is the difference between an airplane and a bird?”

Open

The patient must give a detailed answer, clearly explain and justify his opinion. There is no right or wrong option here: it is important to convey the idea clearly, not to remain silent for a long time, but also not to rush to say as much as possible in a minute. Many open questions concern the patient's habits, affections, actions and thoughts, so there are no uniform answer patterns.

It is better to tell the truth, not to think what conclusion the psychiatrist will draw, what he wants to find in the words.

The doctor may ask:

• What will make you smile?
• What country would you like to live in?
• What kind of music do you listen to all the time?
• What people would you remove from your life if you could?

Closed

Answers require 1 word, it is better to avoid attempts to reason. If the doctor wants the patient to justify his point of view, he will ask for an explanation. Elaborate reasoning is one of the signs of problems with thinking or attempts to hide the truth. So, to the question “Are you a conflict person?” there is no need to remember in detail all the quarrels and behavior in them. Stop answering “yes” or “no.”

Alternative

Choosing from the proposed options seems to be the most difficult for patients, but it is no more difficult than other issues. There is no right or good answer here. The doctor evaluates the logic and coherence of a person’s thoughts.

It is better to answer quickly and clearly, not to think for a long time, and to look the psychiatrist in the eyes. Don't laugh, don't show your tension or excitement.

This method is one of the basic ones in a psychiatric examination. It, like a survey, helps assess the patient’s ability for coherent logical thinking, identify hidden harmful tendencies (towards alcohol, violence, etc.), depression, phobias, mania, and test the stability of the nervous system.

Types of tests:

• To determine the emotional state. This is often a Luscher test with color selection. It is impossible to prepare and “answer correctly”, but it is better to avoid black - it is depression. The first ones to choose are red, green, yellow.
• On the perception of the world. Classic black blot test. Even a negative picture should be explained neutrally.
• On concentration. It is important to calmly go through all the stages, not to fuss, not to look for a double bottom in the task.
• On behavior in a stressful situation. This is often a Schreiner's test: a self-assessed questionnaire. For each “yes” – 1 point. The higher the final number, the worse the resistance to stress. The norm is 4-5. Another option: the Ivanchenko test. You need to rate on a scale from 1 to 4 how often the listed symptoms occur. The final norm values ​​are no more than 45 points.
• To the IQ level. Testing intelligence in a short time (up to half an hour) on questions from different areas: mathematics, logic, physics, etc. It is important to carefully read each task, because many have a catch.

Hypnosis

A person is immersed in a state of trance, which helps him reveal himself, speak honestly, without the influence of external factors and internal attitudes. Hypnosis is used for 2 purposes: to see the patient’s hidden problems or to influence his psyche. During the examination, the method is used for a person who has personality disorders and pathological anxiety. More often, hypnosis is a treatment method used by a psychotherapist.

Indications:

• malfunction;
• neuroses, sleep problems;
• chronic fatigue, anxiety.

Physical examination

If a psychiatrist sees signs of pathologies in a patient, he may prescribe (or conduct) an EEG - electroencephalography. This is a method for diagnosing the state of the brain, which is based on the activity of neurons: nerve cells. Images appear on the monitor with areas of organic lesions in different areas, which helps to clarify the diagnosis and determine its cause. The result can be displayed on paper.

Thanks to encephalography, they diagnose:

• tumors;
• depression;
• inflammation;
• epilepsy at an early stage;
• vascular pathologies.

Indications for the procedure:

• head and neck injuries;
• convulsive states and seizures;
• infections of the brain and blood vessels of the head;
• frequent migraines;
• severe mood swings.

EEG is prescribed to children and adults only when indicated, but the procedure is completely safe. Electrodes are attached to the head, through which the device records signals from neurons for half an hour. Diagnostics can be carried out under load: light flashes and loud sounds are given through glasses and headphones. This is necessary to assess the brain's response to stimuli.

Analyzes

This method does not make sense for assessing a person’s mental health. Tests are taken to clarify the diagnosis, especially if the patient is suspected of having a tumor.

A psychiatrist may prescribe a biochemical blood test, a general urine test and an ECG - cardiogram.

They are needed by drivers and people who get jobs with complex mechanisms: many heart and vascular diseases are a strict ban on such activities.

Inspection results

Source: https://sovets.net/21308-kak-projti-psihiatra.html

Psychiatric examination, consultation, psychiatric medical examination and diagnostics in Moscow at the Alliance Central Medical Health Center

In the modern world, people are increasingly susceptible to stress, chronic fatigue and depression. Mental illness has become a common problem and its incidence is constantly increasing.

This negatively affects not only a person’s personal life, but also prevents the employee from carrying out his professional activities. In connection with the latter, the list of specialties whose representatives must undergo mandatory psychiatric examination is regularly increasing.

Fortunately, modern medicine has learned to identify and successfully cope with signs of mental disorders with timely consultation with specialists.

Psychiatric assessment is the process of collecting and analyzing information related to a person's mental health in order to identify disorders and, if necessary, make a diagnosis.

You may need to undergo such an examination for various reasons, and here are the most common ones:

• personal desire of a person
• at the direction of the employer, if the profession is associated with increased danger, social or industrial activities
• when resolving legal issues: concluding important transactions, disputes about raising children, etc.
• if there is a question about clarifying the psychiatric diagnosis and correcting the prescribed treatment

This type of examination has a number of features and requirements. An important step is a survey and consultation with a psychiatrist.

To conduct an examination that is informative and comfortable for the patient, certain professional skills and personal qualities are required from the doctor: competence, mastery of modern examination techniques, restraint, goodwill and attentiveness.

All this is acquired and improved with experience. Therefore, in order to guarantee efficiency and comfort, the study of your health should be trusted to competent and highly qualified specialists.

Where to get a psychiatric examination

So, if you need such an examination, then you can go to a public hospital.

Unfortunately, low government funding reduces the quality of research and does not allow for modern diagnostic procedures to quickly identify a mental disorder or confirm its absence.

In addition, the high workload of doctors in such places does not allow them to pay due attention to each patient. All this reduces the quality and reliability of the survey.

Psychiatric diagnosis is the identification of painful symptoms and their relationship with psychiatric syndromes and diseases.

The scope of necessary research is decided with each patient individually, depending on his situation and the documents he needs to obtain.

Modern medical centers, such as the Alliance Medical Center, are ready to provide their patients with a wide arsenal of diagnostic methods:

1. Psychiatric consultation and interview
2. Pathopsychological examination and consultation with a psychologist
3. Instrumental and laboratory methods - Neurotest, Neurophysiological test system, EEG

Consultation with a psychiatrist is the most important point in the diagnostic process. The examination allows you to identify mental disorders and analyze them.

In this case, only clinically significant signs are taken into account, so the fact that a person is in a bad mood today will not be a reason to suspect the diagnosis.

An experienced psychiatrist will easily distinguish temporary difficulties from illness and give the right recommendations.

Pathopsychological examination is the second mandatory point of a psychiatric examination. A clinical psychologist, using special conditions and test tasks, helps to obtain a more clear picture of the patient’s psychological state.

Instrumental and laboratory methods allow you to obtain the most accurate and objective results. These procedures are of great importance for the prevention of disorders, as they make it possible to detect not only their presence, but also a predisposition to them. Among modern diagnostic methods it is worth highlighting:

1. Neurotest is a study of immunological parameters of blood serum, on which the functioning of the brain and the development of pathology of the nervous system depend.
2. Neurophysiological test system is a set of techniques that makes it possible to study mental pathologies at the preclinical level (when there are no symptoms of the disorder yet)
3. If necessary, types of studies such as electroencephalography (EEG), magnetic resonance imaging (MRI) of the brain may be prescribed

An individual set of examinations should be prescribed for each patient, taking into account the situation and contraindications. This may range from a basic recruitment kit to a full, detailed study.

Cost of psychiatric examination

The price for providing a psychiatric examination service consists of the following factors:

• the scope and variety of studies that are included in the psychiatric physical examination
• complexity and modernity of the techniques used
• deadlines for receiving results and necessary certificates
• qualifications of specialists
• possibility of on-site consulting

CMZ "Alliance" provides patients with modern and comfortable conditions for undergoing examinations, and doctors with extensive experience will participate in their conduct. The staff of specialists includes highly qualified psychiatrists, including professors and doctors of science. For your convenience, a doctor can come to your home.

The effectiveness of a psychiatric examination is based on the experience and knowledge of specialists in combination with modern methods of laboratory and functional research. All this is done to provide patients with the best access to medical care for their comfort and safety in life.

Ignoring the first signs of disorders or incorrect self-treatment leads to a worsening of the condition and the development of the disease.

In this case, your quality of life will not be reduced and your professional activity will continue.

After the examination and interpretation of the results, the patient receives the necessary documents and a conclusion with recommendations.

All diagnostic measures are carried out only with the voluntary consent of the patient; the decision on what to do with the recommendations received remains with him. Private clinics are ready to provide patients with anonymity and comfort.

Source: https://cmzmedical.ru/stati/psikhiatricheskoe-obsledovanie/

Adequacy test: What is a psychiatric examination and who needs it

A banker with bipolar disorder who stole more than 300 million, a Moscow lawyer who suffered from depression for a long time and shot his colleagues, a nanny with schizophrenia who beheaded a four-year-old girl... These are terrible and real stories that have thundered throughout the country.

Alas, no boss is immune from a situation where a subordinate or colleague begins to behave inappropriately. If it gets out of control, anything can happen - for example, suicide right in the workplace. In this situation, management faces a long trial.

Law enforcement agencies will still need to prove that there is no talk of incitement to suicide, and that the deceased had a psychiatric diagnosis. And if an accident occurs at work, when investigating the causes, supervisory authorities will certainly demand from the employer an act of compulsory psychiatric examination.

Its absence is fraught with heavy fines for the enterprise.

But everyone can prevent a tragedy. There are certain restrictions on work, associated, as a rule, not with the diagnosis itself, but with the person’s condition. Many contraindications are specified in the order of the Ministry of Health.

If an applicant who is undergoing a pre-employment examination has already been diagnosed with a mental disorder from the list and the doctor learns about it, he may refer the patient to a psychiatric commission.

She, in turn, has the right to not allow a person to work if she considers that the disorder is persistent, severe and with frequently worsening manifestations.

When the activities of an organization are associated with increased danger - for example, with the influence of harmful substances, radiation and adverse production factors, employees must regularly - once every five years - undergo a psychiatric examination.

People who do not work in hazardous industries are also sent to “healers of souls” - teachers, drivers, doctors and specialists in the service and catering sectors.

Today, a psychiatric examination can be taken at any medical institution that has the appropriate license. It should be remembered that the decision of a medical psychiatric commission issued in a private medical center will be valid when hiring only if he has a special permit to carry out medical activities.

All this is ready to be provided at the Medical Group . The clinic has been conducting psychiatric examinations for three years and knows all its intricacies first-hand. Specialists with impressive experience work here. And the customer base is impressive.

“Among them are such large enterprises as the Timlyuy cement plant, the Republican Clinical Hospital named after N. A. Semashko, the Ulan-Ude Aviation Plant, Russian Railways OJSC, Ulan-Ude Energo, Rossetti and many others,” says Director of Medical Group Alexander Fedorov. – Our employees are psychiatrists with clinical experience of more than ten years.

The Medical Group employees also conduct scientific activities. They statistically proved that 4 percent of people who are not registered with the republican psychoneurological dispensary and go to get their first job have some kind of mental disorder.

• “This is set out in a scientific work published in the materials of the interregional scientific and practical conference “Prospects for consolidating the achievements of modern narcology and the rational experience of traditional medicine,” which is dedicated to the 40th anniversary of the drug treatment service in Buryatia,” says Alexander Fedorov.
• The medical center’s specialists will help employers get to know each potential employee better, “weed out” applicants with “oddities” and improve the psychological climate in the team.
• Medical Center "Medical Group" : Shumyatskogo Street, 27a.
• Phone: 42-02-91, 30-01-50
• Website medbur.ru
• As an advertisement

Source: https://www.infpol.ru/195065-test-na-adekvatnost-chto-takoe-psikhiatricheskoe-osvidetelstvovanie-i-komu-ono-nuzhno/