See also: [[schizophrenia]], [[Delirium vs psychosis]] ## "medical clearance" 1. assurance that there are no acute medical issues that require immediate specialist treatment (including trauma and intoxication) 2. ruling out underlying medical/organic conditions that may be contributing to altered mental state (hormonal, physiological, infection, etc.) 3. there is no altered level of consciousness (confusion vs psychosis). ## Medical screening goals 1. to treat acute medical issues that require immediate specialist treatment 2. to rule out underlying physical health problems that could be causing psychiatric symptoms and to uncover any physical health problems that may be contributing to presentation, but not causing symptoms 3. to uncover potentially developing or untreated physical health concerns in pts with mental illness, who often do not attend community settings for physical health ## screening for underlying causes "organic screen" - age <12 or >40 at first presentation - acute onset - first presentation w/ no prior psychiatric complaint - new onset symptoms - high suspicion of underling medical complain in elderly with psychiatric complaints (eg infxn, electrolytes) - consider CTB with altered mental status, focal neuro signs, trauma, advanced age, *immunodeficiency* - positive urine dip stick doesn't always mean acute intoxication or drug-induced symptoms - look for signs of alcohol or benzo [[Alcohol Withdrawal Syndrome|withdrawal]] including tachycardia, HTN, tremor, and agitation - age > 40 w/ no prior psych history  - disorientation  - ALOC - visual hallucinations - illusions  - unconcerned regarding personal privacy