A Full Psychiatric Assessment
A psychiatric evaluation is the first step in receiving proper mental health care. The psychiatrist will ask a number of questions about your family and work life, stress sources, traumatic experiences you've had and also any alcohol or drug-related issues.
Background and Histories
A complete psychiatric assessment also known as psych eval, is typically a multi-disciplinary exercise in hospitals that involves psychiatric nurses, psychologists, occupational therapists and social workers. However, the psychiatrist takes the lead role in obtaining a thorough medical history and carrying out a mental state examination. This information can be gathered by direct observation, the person being evaluated and their family members as well as specific psychological tests.
The doctor will inquire with the patient about their symptoms and what they've been up to in the past few weeks, months and years. They will also inquire about your family and personal health. This information will help the doctor to know what is the cause of the symptoms, and if they are caused by a different condition.
During this time, the psychiatrist will take an examination of the medical history and determine whether there is an ancestry of anxiety, depression, or other psychiatric issues within the family. They will also need to find out if the patient is suffering from any physical ailments like heart disease or diabetes, and what medications they are taking or were prescribed in the past.
In addition the psychiatrist will make a note of the current symptoms and the length of time they've been experiencing them for. They will also inquire with the patient about their daily routine, such as their job and home environment. They will also talk about previous treatment and the level of adherence. Families and carers often provide details that the patient hasn't disclosed to them. This is done to show respect for confidentiality and doesn't violate their privacy rights.
Depending on the severity of symptoms, a variety of other tests and evaluations may be required. These could include laboratory tests, blood pressure readings or electroencephalography (EEG), which measures brain activity. They can also take an IQ test, which evaluates cognitive abilities. These tests can test spatial abilities, concentration memory, memory, and communication abilities.
It is important that all psychiatric assessments are conducted by trained and skilled experts. This will ensure that the diagnosis is correct and that the person is offered a treatment plan that is best suited to their needs.
Mental Status Examination
The mental status examination (MSE) can be a painful experience for both the doctor and patient alike. It's a "snapshot" of the patient at a particular moment in time, and is helpful in describing the patient's actions and thoughts at the time. The MSE can also be useful in describing how a person's mental state changes in time, ranging from depression to mania.
The MSE begins with the doctor's initial observations of the patient, usually during the process of taking a history. How a patient interacts the examiner as well as their surroundings can reveal vital details about the underlying disorder in the psyche. This includes the dishevelled look of a person who is depressed 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 taking antipsychotic medication.
When a psychiatric examination is performed it is best to do it when the patient is calm and cooperative. Both the examiner and patient might be uncomfortable during the interview. It is important to make the right impression. The MSE should be only an element of the overall intake evaluation. Its results must be carefully compared with those from other sources like imaging studies or laboratory tests.
Like the physical exam, the MSE does not lend itself to a structured approach and most of it is determined from the physician's unstructured observations during history-taking. However, a thorough MSE should include descriptions of the general appearance and behavior, alertness and attentiveness, motor and speech activity as well as mood and affect, thought and perception as well as attitude and understanding. It should also contain a comprehensive evaluation of higher cognitive functions like parietal lobe function (pictorial construction and right-left discrimination, as well as spatialization of objects) and frontal lobe executive or diffuse cortical functions (judgment, abstract reasoning memory).
It is vital that the MSE is incorporated into the context of the entire intake assessment and that physicians interpret the results with care and sensitivity. A thorough MSE can reveal a broad spectrum of abnormalities, which includes those that are specific to psychiatric disorders however, it should be considered as a single data point in the overall history of the patient and has little clinical value on its own.
Examining the Content of Thoughts
The most important part of the MSE is here the thought content. It should contain details on delusional thoughts (thoughts that aren't true) like grandiose or persecutory idea; hallucinations, (hearing things or seeing things that other people cannot) and preoccupations (such as obsessions or worries) and suicidal thoughts. These questions should be directly asked. The intensity and severity of the pathological thinking should be described. Also whether or not they correspond to the mood (e.g. a depressed patient hearing voices that are angry or encouraging them to kill themselves, versus hallucinations that are peaceful and calm).
Thought process is the coherence, logic, relevance and flow of the client's thinking as they respond to the questions of the examiner during the MSE interview. Physicians also note if the thought process is oriented towards a goal or disorganized and whether it moves rapidly between topics without any clear connection between them. Mental health disorders such as bipolar disorder, schizophrenia, and mania can be indicated by tangential, unorganized and circumstantial thinking processes.
Psychologists and neuropsychologists also test the client's attentional concentration and capacity to store information in short-term memory. This can be determined through self-reports, examiner observations or tests that are brief like counting backwards from 100 and then multiplying it by sevens. They also can assess the client's coping strategies and cognitive performance that is measured through direct questions and observations.
During the MSE psychology, psychologists watch the client's facial expressions as well as body language to determine whether they seem withdrawn or aggressive. They also observe the client's agitation and fidgeting in order to determine whether they are anxious or scared. Psychologists frequently use the MSE in combination with other tests and assessments to establish a diagnosis and formulate a treatment plan. Psychologists are also trained to determine whether the client's behavior is in line with a specific mental illness or is caused by a different reason such as substance abuse, an injury or an adverse reaction to medication. This is essential in determining the appropriate treatment and follow-up.
Assessment of Mood, Anxiety, and Stress
It's normal to experience difficult times. But when these problems start to affect relationships, daily tasks and even sleep, it might be time to make an appointment for a psychiatric assessment. This mental health test is also referred to as a "psych eval" and is usually performed by a psychiatrist or doctor. The procedure can be a little intimidating and usually there's plenty of information you'll need to provide. It's important to remember that your doctor is looking to gather all the information so they can make a correct diagnosis and recommend the best treatment for you.
A psychiatric examination will consist of an examination of your previous medical history and an examination of your body. This is to ensure that there aren't any physical problems that could be causing your symptoms like thyroid problems or neurologic disorder.
Your doctor will also inquire about any psychiatric or medical issues and if you are currently taking any medications. If a patient is not able to give an account of their mental condition, it is essential that their family and caregivers can answer the questions. This is not a breach of confidentiality and allows the doctor to get more details than he would during a face-toface conversation.
During the psychiatric consult, the doctor will examine the emotional state of the patient by watching their body expression and voice. They will also look at their thoughts to see if they are goal-directed and related. The doctor will also examine for instance, how the patient is able to concentrate and switch between ideas during the interview. This is an important aspect of the assessment, as those who are psychotic or manic may not be able to think clearly or quickly shift their focus.
For many people an evaluation for psychiatric issues is their first step towards getting the right treatment they require. Despite the stigma associated with mental illness, it's imperative that anyone who suspects suffering from the symptoms of mental illness seek an evaluation. Don't let your fear or anxiety prevent you from seeking assistance because it could have serious and life-threatening consequences for you and those surrounding you.