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This chapter presents an overview of methods used in clinical assessment, classification, and diagnosis. After outlining the range of assessment options available to clinicians, it describes the typical goals of assessment, including diagnosis, description, treatment planning, and prediction. It also introduces some of the most important variables that affect a clinician’s choices about how to conduct an assessment, including its purpose, the clinician’s theoretical views, the psychometric properties of available assessment instruments, and other contextual factors. The chapter discusses the strengths and weaknesses of human clinical judgment when compared to AI and other actuarial procedures, focusing especially on the errors that clinicians tend to make but strive to avoid. The chapter concludes with a discussion of how the results of clinical assessments are communicated to clients and third parties, and the factors and formats associated with assessment reports.
We present the case of a 48-year-old female patient diagnosed with schizoaffective disorder whose father passed away recently. The patient was facing an appalling mourning which was expressed in the form of behavior disorder and positive psychotic symptoms. Mourning is a natural reaction to the loss of a loved one which involves an internal world transformation, affecting both images of the self and the perceived environment.
Objectives
To analyse the guidelines for mourning approach in chronic psychotic patients.
Methods
A case report is presented alongside a review of the relevant literature regarding mourning in patients with chronic psychotic conditions.
Results
Accepting the loss, working through disruptive emotions, adjusting to a world without the deceased and finding an enduring connection with the loved one are the four tasks of mourning described by Worden. In our case, the patient was immersed in the first two tasks. Difficulties in accepting the loss, tolerating harmful emotions and establishing new affective links were observed, as well as massive projection of unbearable emotions such as sadness, anger, fear and guilt. The available literature identifies these idiosyncrasies as common in the grief processing in patients with chronic psychotic disorders.
Conclusions
In patients with psychosis, difficulties in symbolization, emotional processing and social bonding could have repercussions in the development of grief. However, these features do not imply a pathologic mourning. Tolerating mourning as a normal reaction in psychotic patients is needed, even if the patient expresses non-typical symptoms such as acute psychosis symptoms, hallucinations or behavior disorder.
Disclosure
No significant relationships.
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