A Full Psychiatric Assessment
A psychiatric examination is the first step towards receiving proper mental health care. The psychiatrist will ask a lot questions about your home and work environment, stress sources, traumatic experiences you've had and any alcohol or drug-related issues.
Background and History
A full psychiatric assessment, or psych eval is typically a multi-disciplinary process in hospital settings, which includes psychiatric nurses, psychologists, occupational therapists and social workers. However, the psychiatrist plays a lead role in taking a detailed medical history and performing an examination of mental health. The information can be gathered through direct observation of the person being assessed themselves and carers, and also through specific psychological tests.
The doctor will inquire with the person about their symptoms and what they've been up to in the past few weeks, months and years. They will also want to know about their personal and family health. This will help the doctor to know what is the cause of the symptoms and whether they are caused by a different condition.
In this stage during this time, the psychiatrist will conduct an medical history and find out whether there is an ancestry of anxiety, depression or other psychiatric issues within the family. They will also want to find out if the patient suffers from any physical issues, such as diabetes or heart disease, and what medications they are taking or were prescribed in the past.
The psychiatrist will also be aware of any current symptoms and the length of time they've been suffering. They will also inquire with the patient about their life including their work and home environment. They will also discuss prior treatment and the degree of adhering to. Carers and families often share information the patient hasn't told them. This is done out of respect for confidentiality and does not violate their privacy rights.
Based on the severity of symptoms, a variety of additional tests and examinations may be required. These could include laboratory tests, blood pressure readings or electroencephalography (EEG), which measures brain activity. It is also possible to use IQ tests, which test the ability to think. These tests test spatial abilities, concentration, memory, and communication skills.
All psychiatric assessments must be conducted by professionals who are skilled and knowledgeable. This will ensure that the diagnosis and treatment plan are correct.
Mental Status Test
Mental status examinations (MSEs) can be frightening for both the patient and physician. It is an "snapshot" of the patient at a particular moment, and is useful in describing the patient's actions and thoughts at the time. The MSE can also be useful in describing how a patient's mental state changes over time, such as from depression to mania.
The MSE begins with the physician's initial observations of the patient, usually during the history-taking. How a patient interacts the examiner and their environment can reveal important information about the underlying disorder in the psyche. This includes the discolored appearance of a depressed person or the flamboyant style of manic patients. It can also be a sign of a lack of motivation or effort from someone who is depressed or on antipsychotic medication.
It is recommended to conduct a psychiatric test when the patient is relaxed, cooperative and willing. Both the patient and examiner might feel uncomfortable during the interview. It is crucial to present a positive impression. The MSE should only be just a tiny portion of the overall intake assessment. Its results should also be compared carefully with those from other sources like imaging studies or tests in the laboratory.
As with the physical exam, the MSE is not as well suited to a structured approach, and the majority of it is gathered by the physician's unstructured observations during history-taking. A detailed MSE will include descriptions of behavior and appearance as also alertness and focus to speech and motor activities, mood and affect, perception and thought and attitude as well as awareness. It should also include an assessment of higher cognitive abilities such as parietal-lobe functions (pictorial representation as well as right-left discrimination and localization of objects in space).
It is crucial that the MSE is embedded within the context of the full intake assessment and that physicians interpret the results with sensitivity and care. A thorough MSE will reveal a wide range of abnormalities, including many that are specific to psychiatric disorders, however, it must be seen as a single more info point of data within the overall patient's history and is of little clinical value by itself.
Examining Thought Content
The thought content section is the largest of the MSE sections and should contain information about delusional thinking (thoughts that are untrue) - such as jealous, persecutory, or grandiose thoughts; hallucinations (hearing or seeing things others do not) Preoccupations (such as worries, obsessions or phobias); and suicidal thoughts. These questions should be explicitly asked. The severity and the extent of the psychotic thinking should be described. Also, whether or not they are in sync with the mood (e.g. A depressed patient may hear voices that are angry and urge them to commit suicide, as opposed to calm and peaceful hallucinations.
The thought process is the coherence, logic, and relevance of the client's responses to the MSE interviewer's questions. Doctors also look for signs that the thought process is disorganized or goal-directed and if it flits from one topic to another without a apparent connection between them. Mental health conditions like schizophrenia, bipolar disorder, and mania can be indicated by tangential, unorganized, and circumstantial thought processes.
Additionally, psychologists and neuropsychologists evaluate the capacity of the client to pay on a single subject and then hold it in memory. This can be assessed by observing examiners, the client's self-report or tests such as counting backwards from 100 by 7s. They also evaluate the client's strategies to cope and cognitive performance in everyday life, which is assessed through direct questioning and behavioral observation.
During the MSE the psychologists will observe the client's body language and facial expressions to determine if they appear nervous or shy. They also look at the client's nervousness or fidgeting to determine if they are nervous or anxious. Psychologists utilize the MSE together with other tests and assessments to diagnose and develop a treatment plan. Psychologists are also trained to detect the signs that a client's behavior may be in line with a specific mental illness or is due to another cause such as substance abuse, an injury or an adverse reaction to medication. This information is crucial to determining the best treatment option and follow-up.
Assessment of Mood, Anxiety and Stress
It's normal for people to experience difficult times. However, when these issues start to affect relationships, everyday tasks or even sleep, it might be a good idea to schedule an appointment for a psychiatric assessment. Also known as a psych eval or mental health examination, this type of test is usually performed by a psychiatrist or physician. The process can be a little intimidating and usually there's a lot of information that you'll have to share. It's important to remember that your doctor wants to gather all the information so they can make a correct diagnosis and recommend the right treatment for you.
A psychiatric examination will consist of a review and physical examination of your medical history. This is to confirm that there aren't any physical issues that could be causing your symptoms such as thyroid issues or neurologic disorder.
In addition your psychiatrist will also inquire about any other psychiatric or medical issues you've faced in the past and if you're currently taking any medications currently. In cases where patients are not able to provide a medical account due to their mental state it is essential that their caregivers and family members can answer the physician's questions. This isn't a breach of confidentiality, and it permits the doctor to gather more information than he would in a face-to-face interview.
During the psychiatric consultation, the doctor will examine the emotional state of the patient through observation of their body expression and voice. They will also assess their thoughts to determine if they are related and goal-directed. The doctor will examine, for example, how the patient can focus and switch between thoughts during the interview. This is an important aspect to the assessment because psychotic or manic patients might not be able think clearly and swiftly shift their focus of thought.
A psychiatric assessment is often the first step in getting the treatment you require. Despite the stigma that surrounds mental illness, it's essential that anyone who suspects they're suffering from the symptoms of a mental disorder seek out an evaluation. Don't let your fear or anxiety prevent you from seeking help as it could have serious and life-threatening consequences for you and those surrounding you.