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Patient is in distress means he looks in pain , sorrow or anxious.
We have general appearance of patient under Constitutional system which includes examination of how patient appears ? his body habitus (overweight or malnourished) , physical deformities , attention to grooming, nutrition status.
This exam does not include displaying emotion status / emotions through facial expression.
in Psychiatric exam physician normally asks questions to evaluate Patient's
1. judgment and insight
2. remote and recent memory
3. orientation to place person and time
or he will look for patient's
4. mood and affect.
Affect means displaying emotions through facial expression, patient is in sorrow or distress is nothing but patients affect.
So crediting under psychiatric system is more appropriate
