Basu Debasish, Basu Aniruddha, Ghosh Abhishek
Drug De-addiction and Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Indian J Psychiatry. 2018 Feb;60(Suppl 4):S457-S465. doi: 10.4103/psychiatry.IndianJPsychiatry_13_18.
A large proportion of patients with substance use disorders have clinical comorbidities, either medical or psychiatric. An initial assessment is necessary initially for prompt identification and management of any psychiatric or medical emergency, and thereafter a more detailed assessment for the comprehensive understanding of the individual. This should be done keeping in mind the goals of both immediate and long term assessment so that a comprehensive but individualized, context and culture sensitive, reality based, recovery-oriented management plan can be formulated. Assessment should consist of not only history-taking, physical and mental status examination but also laboratory and instrument based assessment as needed. During assessment, collateral reports and past medical records are valuable additions along with self-report. Since substance use disorders influence various aspects of daily life, hence medical, social, occupational, religious, spiritual, financial and legal aspects should be evaluated. Overall, the assessment needs to be diagnosis and management focused, covering the various bio-psycho-social domains relevant to the individual.
很大一部分物质使用障碍患者存在临床合并症，包括医学或精神方面的。最初进行初步评估对于迅速识别和处理任何精神或医疗紧急情况是必要的，此后进行更详细的评估以全面了解个体情况。这样做时应牢记即时和长期评估的目标，以便能够制定一个全面但个性化、对背景和文化敏感、基于现实、以康复为导向的管理计划。评估不仅应包括病史采集、身体和精神状况检查，还应根据需要进行基于实验室和仪器的评估。在评估过程中，旁证报告和既往病历与自我报告一样都是有价值的补充。由于物质使用障碍会影响日常生活的各个方面，因此应评估医学、社会、职业、宗教、精神、财务和法律等方面。总体而言，评估需要以诊断和管理为重点，涵盖与个体相关的各种生物心理社会领域。
