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THE BEST TESTS PHYSICIANS USE TO DETECT COGNITIVE ABILITIES & OTHER MENTAL ILLNESSES
MoCA Test allows healthcare providers to quickly assess a patient’s cognitive health and accurately make more informed healthcare decisions
A useful cognitive screening tool for many illnesses, including:
- Parkinson’s disease
- Lewy Body
- Fronto-temporal dementia
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Narcissistic Personality Disorder
Narcissistic personality disorder (NPD) is a cluster B personality disorder defined as comprising a pervasive pattern of grandiosity (in fantasy or behavior), a constant need for admiration, and a lack of empathy.
In the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5),  NPD is defined as comprising a pervasive pattern of grandiosity (in fantasy or behavior), a constant need for admiration, and a lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by the presence of at least 5 of the following 9 criteria:
- A grandiose sense of self-importance
- A preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
- A belief that he or she is special and unique and can only be understood by, or should associate with, other special or high-status people or institutions
- A need for excessive admiration
- A sense of entitlement
- Interpersonally exploitive behavior
- A lack of empathy
- Envy of others or a belief that others are envious of him or her
- A demonstration of arrogant and haughty behaviors or attitudes
In addition, NPD is characterized by the presence of both grandiosity and attention seeking.
NPD is not associated with any specific defining physical characteristics; however, physical consequences of substance abuse, with which NPD is often associated, may also be apparent on examination. Mental status examination may reveal depressed mood. Patients in the throes of narcissistic grandiosity may display signs of hypomania or mania.
Patients with narcissistic personality disorder (NPD) often present to the healthcare professional after hitting “rock bottom” in their careers or personal lives or at the strong urging of a family member who insists that they get professional help for their behavior.
Because NPD, by its nature, involves a haughty disregard for others and an insistence on one’s own innate superiority, narcissistic patients are unlikely to recognize their need for treatment and even less likely to seek help of their own accord. For this reason, patients with a diagnosis of NPD alone (ie, with no concomitant axis I diagnoses) make up a very small percentage of the total patient population seen by mental health professionals.
To be diagnosed with NPD, a patient must demonstrate a consistent and long-standing pattern of maladaptive behavior, starting in adolescence or early adulthood, that exemplifies 5 or more of the 9 criteria listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Although many people display these criteria to some degree, NPD is diagnosed only when the symptoms are pervasive, debilitating, and socially and personally destructive.
Patients with NPD are also acutely sensitive to rejection or criticism and may avoid people or situations where there is the possibility of feeling “less than.” When criticized, such patients may become furious and lash out or withdraw into a shell of sullen hate. At their core, both of these reactions are thought to be due to intrinsically low self-esteem or a feeling of inferiority. 
The Hare Psychopathy Checklist-Revised (PCL-R) is a diagnostic tool used to rate a person’s psychopathic or antisocial tendencies. It was developed in the 1970’s by Dr. Robert Hare, a Canadian professor and researcher renowned in criminal psychology, who has spent three decades studying the concept known as the psychopath and based partly on Hare’s work with prison inmates in Vancouver. It is accepted by many in the field as the best method for determining the presence and extent of psychopathy in a person.
40 : A prototypical psychopath would receive a maximum score of 40
30 : A score of 30 or above qualifies a person for a diagnosis of psychopathy
22 : Many non-psychopathic criminal offenders score around 22
5 : People with no criminal backgrounds normally score around 5
0 : someone with absolutely no psychopathic traits or tendencies would receive a score of zero
Delusional disorder, previously called paranoid disorder, is a type of serious mental illness — called a “psychosis”— in which a person cannot tell what is real from what is imagined. The main feature of this disorder is the presence of delusions, which are unshakable beliefs in something untrue. People with delusional disorder experience non-bizarre delusions, which involve situations that could occur in real life, such as being followed, poisoned, deceived, conspired against, or loved from a distance. These delusions usually involve the misinterpretation of perceptions or experiences. In reality, however, the situations are either not true at all or highly exaggerated.
People with delusional disorder often can continue to socialize and function quite normally, apart from the subject of their delusion, and generally do not behave in an obviously odd or bizarre manner. This is unlike people with other psychotic disorders, who also might have delusions as a symptom of their disorder. In some cases, however, people with delusional disorder might become so preoccupied with their delusions that their lives are disrupted.
There are different types of delusional disorder based on the main theme of the delusions experienced. The types of delusional disorder include:
- Erotomanic. Someone with this type of delusional disorder believes that another person, often someone important or famous, is in love with him or her. The person might attempt to contact the object of the delusion, and stalking behavior is not uncommon.
- Grandiose. A person with this type of delusional disorder has an over-inflated sense of worth, power, knowledge, or identity. The person might believe he or she has a great talent or has made an important discovery.
- Jealous. A person with this type of delusional disorder believes that his or her spouse or sexual partner is unfaithful.
- Persecutory. People with this type of delusional disorder believe that they (or someone close to them) are being mistreated, or that someone is spying on them or planning to harm them. It is not uncommon for people with this type of delusional disorder to make repeated complaints to legal authorities.
- Somatic. A person with this type of delusional disorder believes that he or she has a physical defect or medical problem.
- Mixed. People with this type of delusional disorder have two or more of the types of delusions listed above.