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In caring for the acutely psychotic patient, the psychiatrist is similar to a general medical physician. He uses the traditional methods of clinical medicine: (1) data gathering (history, physical examination, laboratory investigation), (2) differential diagnosis, and (3) treatment. The acutely psychotic patient is presumed to be suffering a pathological process that has a specific treatment. The doctor’s role tends to be more authoritarian than in many other areas of psychiatry—the psychiatrist must often take control of the situation, prescribing and proscribing rather than negotiating. Because judgment is impaired and decisions unrealistic, the acutely psychotic patient tends to play a relatively minor part in determining his emergency care. Although the psychiatrist values his alliance with the patient, with an acute psychotic there may be no real alliance established, or it may be subject to violation if good care must override patient wishes.
KeywordsPsychotic Patient Acute Psychosis Affective Disturbance Subacute Bacterial Endocarditis Functional Psychos
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