A Full Psychiatric Assessment
A psychiatric assessment is the first step to receiving proper mental health care. The psychiatrist will ask you a number of questions regarding your work and home life, sources of stress, any major traumatic experiences you have endured, and whether you've had issues with alcohol or drugs.
Background and History
A full psychiatric examination, also known as psycheval, is a multidisciplinary process that occurs in hospitals. It involves psychiatric nursing, psychologists, occupational therapy, and social workers. The psychiatrist, however, takes a lead role in obtaining a thorough medical history and carrying out a mental state examination. This information may be obtained from direct observation or the person being assessed themselves and carers, and also through specific psychological tests.
The doctor will ask the patient about their symptoms and what they've been doing over the past few months, weeks and years. They will also ask about your family and personal health. This information can aid the doctor in determining the cause of symptoms and if they're the result another illness.
During this phase, the psychiatrist will take an medical history and determine whether there is a history of anxiety, depression or other psychiatric conditions in the family. They will also ask if there are any physical issues, such as heart disease or diabetes, and what medications the person is taking or has been prescribed.
The psychiatrist will also take note of any symptoms that are present and the amount of time they have been present. They will also ask the patient about their daily routine including their work and home life. They will also discuss the person's previous treatment as well as the degree of compliance to it. In many cases, family members and carers provide information that the patient hasn't previously disclosed, but this is a matter of confidentiality and does not violate their rights to privacy.
Depending on the severity, additional tests and examinations may be needed. These could include laboratory tests, blood pressure readings or electroencephalography (EEG), which measures brain activity. They might also use IQ tests, which test cognitive abilities. They can test spatial abilities memory, concentration, memory, and communication abilities.
It is crucial that all psychiatric tests are conducted by trained and experienced experts. This will ensure that the diagnosis and treatment plan are accurate.
Mental Status Examination
The mental status examination (MSE) can be a painful experience for the physician as well as the patient. It's an "snapshot" of the patient in a specific moment, and is useful to describe the patient's behavior and thoughts at that moment. The MSE can also be useful in describing how a patient's state mind changes over time. For instance, from depression to manic episodes.
The MSE begins when the physician begins to make the first observations about the patient. This is typically taken during the recording of the history. How a patient interacts the examiner and their environment can reveal vital details about the underlying psychiatric disturbance. This includes the discolored appearance of a depressed individual or the provocative style of manic patients. It could also be a sign of lack motivation or effort in the person who is depressed or on antipsychotic medication.
When a psychiatric examination is undertaken, it is best done when the patient is relaxed and cooperative. Both the patient and examiner may feel uncomfortable during the interview. It is crucial to convey the right impression. The MSE should be a relatively short part of the overall intake assessment, and the results should be considered together with the results from other sources like imaging studies or laboratory tests.
Similar to the physical exam it is the MSE is not as well suited to a structured approach, and much of it is obtained by the physician's unstructured observations during history-taking. However, a thorough MSE should include descriptions of general appearance and behavior, alertness and attention as well as speech and motor activity as well as mood and affect, thought and perception, attitude and insight. It should also include a detailed evaluation of higher cognitive abilities such as parietal lobe functions (pictorial construction and discrimination between right-left and left, spatialization of objects) and frontal lobe executive or diffuse cortical functions (judgment, abstract reasoning, memory).
It is essential that the MSE be viewed in the context of a full intake evaluation and that doctors interpret results with care and sensitivity. A thorough MSE will reveal a wide variety of abnormalities, including many that are specific to psychiatric disorders, however, it should be considered as a singular data point in the patient's overall history and has little clinical value on its own.
Assessment of Thought Content
The thought content section is the most extensive of the MSE sections and should include information on delusional thinking (thoughts that are not true) - such as jealous, persecutory, or grandiose thoughts; hallucinations (hearing or seeing things others do not) and preoccupations (such as worries, obsessions or phobias) and suicidal thoughts. These questions should be directly asked. The severity and the extent of the psychopathic thinking needs to be described. Also the extent to which they correspond to the mood (e.g. a patient who is depressed hearing voices that are angry or encouraging them to kill themselves, versus hallucinations that are soothing and calm).
Thought process is the coherence, logic, relevance and flow of the client's thoughts as they psychiatric mental health assessment respond to the questions of the examiner during the MSE interview. Doctors also look for signs that the thought process is oriented towards a goal or disorganized and whether it moves rapidly from one topic to another without any apparent connection between them. Disorganized, tangential, and circumstantial connections are thought processes that may indicate mental health conditions such as schizophrenia, mania and bipolar disorder.
Additionally, psychologists and neuropsychologists evaluate the ability of the client to pay attention and briefly hold information in memory. This can be assessed through examiner observations, client self-report or brief tests such as counting backwards from 100 by 7s. They also evaluate the client's strategies for coping and cognitive functioning in daily life, which is assessed through direct questioning and behavioral observation.
During the MSE psychologists will be observing the client's facial expressions and body language to determine if they seem aggressive or withdrawn. They also examine the client's restlessness and fidgeting in order to determine whether they are anxious or fearful. Psychologists utilize the MSE alongside other tests and assessments to identify and develop a treatment plan. Psychologists are also trained to determine if the client's behavior is consistent with a particular mental illness or is instead caused by a different reason like substance abuse, an injury or medication side effects. This information is crucial in determining the best treatment and follow-up.
Assessment of Mood, Anxiety and Stress
It's normal for people to experience difficult times. However, when these issues begin to affect relationships, daily activities and even sleep, it could be a good idea to schedule an appointment for a psychiatric evaluation. Also known as a psych eval and a mental health check, this exam is typically performed by a psychiatrist or a doctor. It can be daunting, and you'll have to provide a lot of personal details. It's important to remember that your doctor wants to gather all the relevant information so that they can make an accurate diagnosis and recommend the best treatment for you.
A psychiatric examination will consist of a review and physical examination of your medical history. This is to make sure that there are no physical problems that could be causing your symptoms such as thyroid problems or neurologic disorder.
In addition, your psychiatrist will ask you about any other psychiatric or medical problems you've had in the past and whether you're currently taking any medications at present. If a patient is unable to provide a account due to their mental condition it is essential that their caregivers and family members can answer the doctor's questions. This is not a violation of confidentiality and it allows the doctor to obtain more information than he could in a face-to-face conversation.
In the psychiatric consultation the doctor will evaluate the emotional state of the patient through observation of their body speech and tone of voice. They will also assess their thoughts to determine if they're focused and related. The doctor will examine for instance, how the patient can concentrate and switch between ideas during the interview. This is an important aspect to the evaluation as psychotic or manic patients might not be able to think clearly and swiftly shift their focus of thought.
For many, a psychiatric evaluation is the first step to get the right treatment they require. Despite the stigma associated with mental illness, it's essential that anyone who suspects they're suffering from the symptoms of a mental disorder seek an evaluation. Don't let your fear or anxiety prevent you from seeking help as it could have serious and life-threatening consequences for yourself and those around you.