A Full Psychiatric Assessment
A psychiatric assessment is the first step to receiving the proper treatment for your mental health. The psychiatrist will ask you a number of questions about your work and private life, sources of stress, any major traumatic experiences you have experienced, and if you have had any alcohol or drug problems.
Background and History
A complete psychiatric evaluation, also known as psych eval, is typically a multi-disciplinary process in hospitals that involves psychiatric nurses, occupational therapists, psychologists and social workers. The psychiatrist is the one who takes the medical records in detail and conducts a mental exam. The information can be gathered from direct observation or the person being evaluated themselves and carers, and also through specific psychological tests.
The doctor will ask about the patient's symptoms as well as what he or she has done in the last few weeks, months, and years. They will also ask about your family health and personal health. This information can aid the doctor in determining what is causing symptoms and if they are the result of another illness.
During this phase, 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 ask whether there are any physical concerns such as diabetes or heart disease, and what medication the patient is taking or has been prescribed.
The psychiatrist will also keep track of any symptoms that are present and the length of time they've been experiencing symptoms. They will also inquire with the patient about their life including their work and home environment. They will also discuss prior 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 infringe on their privacy rights.
Depending on the severity, other tests and/or observations 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 measure cognitive abilities. They can test spatial abilities as well as concentration, memory and communication skills.
It is essential that all psychiatric assessments are performed by qualified and skilled professionals. This will ensure that the diagnosis is accurate and that the patient is offered a treatment plan that is best suited to their needs.
Mental Status Examination
The mental state examination (MSE) can be a painful experience for both the physician and patient alike. It's an "snapshot" of the patient at a specific moment, and is useful in describing the patient's actions and thoughts at that moment. The MSE is also helpful in illustrating the way a patient's mind changes over time. For example, from depression to manic episodes.
The MSE begins with the physician's initial observations of the patient during the taking of a medical history. The way a patient interacts and behaves in front of the examiner can reveal something about the root of the mental disorder. This includes the discolored appearance of a depressed person or the exuberant manner of manic patients. It could also be a sign of lack of motivation or effort in the person who is depressed or on antipsychotic medication.
If a psychiatric test is undertaken, it is best done when the patient is at ease and cooperative. It is a stressful and uncomfortable experience for both the patient and the examiner and it is essential to leave a good impression. The MSE should be a relatively short part of the overall intake evaluation, and the results should be carefully evaluated in conjunction with findings from other sources, such as imaging studies or lab tests.
The MSE is less structured than the physical exam, and the majority of the information is collected by the physician during the history-taking process. Nevertheless, a detailed MSE should include descriptions of the general appearance and behavior, alertness and attentiveness, motor and speech activity, mood and affect, thinking and perception as well as attitude and insight. It should also include an assessment of higher cognitive capabilities such as parietal-lobe functions (pictorial representation of right-left discrimination, right-left localization and the representation of objects within space).
It is essential that the MSE be considered in the context of a complete intake assessment and that doctors interpret the results with care and sensitivity. A thorough MSE can reveal a broad range of abnormalities, including some that are specific to psychiatric disorders however, it should be considered as a single data point within the overall patient's history and is of little clinical value by itself.
Assessing Thought Content
The largest section of the MSE is the thought content. It should include information on delusional thoughts (thoughts which are not true) like persecutory or grandiose idea hallucinations (hearing things or seeing things that other people cannot); preoccupations, (such as worries or obsessions); and suicidal thinking. These questions should be clearly asked. The intensity and extent of the psychopathic thoughts should be documented, including whether they are mood-congruent or incongruent (e.g. A depressed patient might hear voices that are angry and urge them to commit suicide, versus calm and peaceful hallucinations.
The thought process is the coherence, logic, and relevance of the client's responses to the MSE interviewer's questions. Physicians will also note whether the thought process is unorganized or goal-oriented, and if it jumps between one topic and the next without a clear connection. Disorganized, tangential or circumstantial associations are adhd assessment psychiatrist thought processes that can indicate mental health conditions such as mania, schizophrenia and bipolar disorder.
Psychologists and neuropsychologists also assess the client's attentional focus and ability to hold information in short-term memory. This can be determined through self-reports, examiner observations or brief tests such as counting backwards from 100 and multiplying it by sevens. They also evaluate the client’s coping mechanisms and cognitive functioning by assessing it by direct questions and behavioral observations.
During the MSE psychology, psychologists watch the client's facial expressions as well as body language to determine whether they appear withdrawn or aggressive. They also watch the client's agitation or fidgeting to determine if they're scared or anxious. Psychologists typically use the MSE along with other tests and assessments to make diagnose and create an appropriate treatment plan. Psychologists are trained to determine whether a person's behavior is caused by a mental illness, or if it is caused by another cause like alcohol abuse, an accident or a medication adverse effect. This is essential in determining the appropriate treatment and follow-up care.
Evaluation of Mood, Anxiety, and Stress
It's normal for people to experience difficult times. But when these problems begin to affect relationships, daily activities and even sleep, it could be a good idea to schedule an appointment for a psychiatric examination. Also called a psych eval, this mental health test is usually performed by a psychiatrist or a doctor. The procedure can be a little intimidating and you'll usually have a lot of information that you'll need to disclose. But, it's essential to realize that your therapist is trying to get all the facts so they can make an accurate diagnosis and suggest the best treatment for you.
A psychiatric assessment will include an examination of your prior medical history and physical examination. This is to confirm that there are no physical issues that could be causing your symptoms such as thyroid problems or a neurologic disorder.
In addition the doctor will ask you about any other medical or psychiatric issues you've experienced in the past and if you're currently taking any medications currently. In cases where the patient is unable to provide an account of their mental state it's important that their family members and caregivers can answer the questions. This is not a violation of confidentiality and it allows the doctor to get more complete information than would be possible during a face-toface 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. For example the doctor will assess how the patient is able to focus during the interview and whether they are able to easily switch between ideas. This is an essential aspect to the assessment because a manic or psychotic patient may not be able to think clearly and quickly shift their focus.
A psychiatric evaluation is usually the first step towards getting the care you need. Despite the stigma that surrounds mental illness, it's imperative that anyone who suspects they're suffering from the symptoms of a mental disorder seek out an evaluation. Don't let fear or anxiety prevent you from seeking assistance because it could have serious and life-threatening implications for you and the people surrounding you.