A Full Psychiatric Assessment
A psychiatric evaluation is the first step in getting proper mental care. The psychiatrist will ask a many questions about your home and work life and stress-related factors, as well as traumatic events that you've been through and any alcohol or drug-related issues.
Background and Histories
A full psychiatric assessment, or psych eval, is usually a multi-disciplinary procedure in hospital settings, which involves occupational therapists, psychologists and social workers. However, the psychiatrist takes the lead role in taking a complete medical history and performing an examination of mental health. The information can be gathered from direct observation or the person being examined themselves and carers, and also through specific psychological tests.
The doctor will ask about the patient's symptoms and what he or she has done in the last few months, weeks, and years. They will also ask questions about their personal and family health. This information will help the doctor determine what is causing symptoms and if they're caused by a different condition.
During this time where the psychiatrist will take a medical history and find out whether there is any history of depression, anxiety or other psychiatric disorders in the family. They will also want find out if the patient suffers from any physical issues, such as diabetes or heart disease, and what medications they are taking or have been prescribed in the past.
Additionally the psychiatrist will take note of current symptoms and how long they have been present. They will also ask about the person's lifestyle, including their job and home environment. They will also discuss previous treatment and the degree of adherence. Most often, family members and carers offer information that the patient hasn't disclosed, but this is an issue of confidentiality and does not violate their right to privacy.
Depending on the severity of the issue, other tests and observations might 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 assess cognitive ability. These tests measure spatial abilities, concentration, memory, and communication skills.
All psychiatric assessments should be performed by professionals who are skilled and knowledgeable. This will ensure the diagnosis is correct and that the patient receives a treatment plan that is most suitable for their needs.
Mental Status Examination
Mental status examinations (MSEs) can be a terrifying experience for both the patient and physician. It is an "snapshot" of the patient at a specific moment, and is useful to describe the patient's behavior and thoughts at the time. The MSE can also be helpful in showing how a patient's mental state changes over time, for example, from depression to mania.
The MSE starts when the doctor begins to make the first observations about the patient. It is usually done during the taking of the history. The manner in which a patient interacts with and behaves around the examiner can reveal an awful lot about the root cause of mental disorder. This can be the case with the sloppy appearance of a depressed patient, or the provocative style of a manic patient. It could also be a sign of lack motivation or effort in the person who is depressed or taking antipsychotic medication.
It is best to conduct a psychiatric examination when the patient is relaxed and cooperative. It can be a difficult and uncomfortable experience for both the patient and the examiner and it is essential to leave a good impression. The MSE should be a short part of the overall intake evaluation and the results should be considered in conjunction with findings from other sources such as laboratory tests or imaging studies.
The MSE is not as structured as the physical exam and most of the information is collected by the doctor during the process of taking a history. A thorough MSE will include descriptions of the appearance and behavior as also alertness and focus, motor and speech activities such as mood and affect, perception and thinking and attitude as well as awareness. It should also include an evaluation of higher cognitive abilities such as parietal-lobe functions (pictorial representation of right-left discrimination, right-left localization and the representation of objects in space).
It is important that the MSE be viewed as part of a full intake evaluation and that doctors interpret results with sensitivity and care. A thorough MSE can reveal a broad range of abnormalities, including many that are specific to psychiatric disorders, however, it must be seen as a single point of data within the overall patient's history and has little clinical value on its own.
Assessment of Thought Content
The most important part of the MSE is the thought content. It should contain information about delusional ideas (thoughts that are not real) like grandiose or persecutory idea hallucinations (hearing things or seeing things that others can't) and preoccupations (such as obsessions or worries) and suicidal thought. These questions should be addressed directly. The intensity and extent of the pathological thoughts should be described, including whether they are mood congruent or incongruent (e.g. A person suffering from depression may hear voices that are angry and prompt to commit suicide, versus calm and soothing hallucinations.
The thought process is the logic, relevance and coherence of the client's responses MSE interviewer's questions. Physicians also note if the thought process is oriented towards a goal or disorganized and if it flits from one topic to another without any obvious connection between them. Disorganized, tangential and circumstantial associations are thought processes that may be indicators of mental health issues such as mania, schizophrenia and bipolar disorder.
Psychologists and neuropsychologists also assess the client's attentional concentration and capacity to store information in short-term memory. This can be determined by examiner observations, self-reports or brief tests, such as counting backwards starting at 100 and multiplying it by sevens. They also evaluate the client's coping strategies and their cognitive performance in daily life, which can be measured through direct questioning and behavioral observations.
During the MSE psychological evaluation, psychologists look at the client's facial expressions and body language to assess whether they appear withdrawn or aggressive. They also observe the client's agitation or fidgeting to determine if they are scared or anxious. Psychologists often employ the MSE along with other assessments and tests to determine a diagnosis and formulate the treatment plan. Psychologists are also trained to detect whether the client's behavior is consistent with a particular mental illness or is due to a different cause such as substance abuse, an injury or medication side effects. This information is crucial in determining the best treatment and follow-up.
Evaluation of Mood, Anxiety and Stress
It's normal to experience difficult times. But when these difficulties begin to affect relationships, everyday tasks and even sleep, it could be a good idea to schedule an appointment for a psychiatric assessment. Also called a psych eval and a mental health check, this exam is typically performed by a psychiatrist or a doctor. The procedure isn't easy and usually there's a lot of information that you'll need to disclose. But, it's essential to understand that your therapist will be trying to gather all the information they need so that they can make a precise diagnosis and recommend the most effective treatment for you.
A psychiatric examination will consist of a review of your past medical history as well as a physical examination. This is to make sure that your symptoms aren't caused by a physical condition such as a thyroid disorder or a neurological disorder.
Your psychiatrist will also ask about any psychiatric or medical conditions and whether website you are currently taking any medications. If a patient is unable to provide a history due to their mental state it is crucial that the caregivers and family members of the patient can answer the doctor's questions. This is not a breach of confidentiality and it permits the doctor to obtain more information than he would during a face-toface conversation.
In the psychiatric consultation the doctor will evaluate the patient's emotional state by observing their voice tone and body language. They'll also look at their thoughts to determine if they're focused and related. The doctor will examine for instance, how well the patient can focus and switch between ideas during the interview. This is a crucial aspect of the evaluation, since a patient who is psychotic or manic may not be able think clearly or quickly shift their focus.
A psychiatric evaluation is usually the first step to get the care you need. It is essential that anyone who believes they suffer from symptoms of mental illness seeks an evaluation. Don't let your fear or anxiety stop you from seeking help. It could have serious consequences for you and others around.