A Full Psychiatric Assessment
A psychiatric examination is the first step to receiving proper mental health care. The psychiatrist will ask a many questions about your home and work environment and stress-related factors, as well as traumatic events that you've been through and any drug or alcohol issues.
Background and History
A complete psychiatric evaluation, or psych eval is typically a multi-disciplinary process in hospital settings that involves psychologists, occupational therapists and social workers. The psychiatrist is the one who creates a detailed medical record and performs a mental examination. The information can be gathered directly from observation or the person being evaluated themselves and carers, and also through specific psychological tests.
The doctor will inquire about the patient's symptoms and what he or she has done in the past few months, weeks, and years. They will also ask questions about personal and family health. This information will allow the doctor to know what is causing the symptoms and whether they are caused by a different condition.
During this time, the psychiatrist will take an medical history and find out whether there is a history of depression, anxiety or other psychiatric disorders in the family. They will also inquire whether there are any physical problems like heart disease or diabetes and what medication the patient is taking or was prescribed.
The psychiatrist will also keep track of any current symptoms and the length of time they have been present. They will also inquire about the person's life such as their job and their home environment. They will also discuss previous treatment and the degree of compliance. Families and carers often provide information the patient hasn't told them. This is done to show respect for confidentiality and doesn't violate their privacy rights.
Depending on the severity, 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 test cognitive ability. These can test spatial skills, concentration, memory and communication abilities.
All psychiatric assessments must be conducted by professionals who are skilled and knowledgeable. This will help ensure that the diagnosis is correct and that the person receives a treatment plan that best suits their needs.
Mental Status Examination
Mental status examinations (MSEs) can be a terrifying experience for both the patient and the physician. It is a "snapshot" of the patient at a specific moment in time, and is helpful in describing the patient's actions and thoughts at the time. The MSE is also useful in describing the way a patient's mind changes over time. For instance, from depression to manic episodes.
The MSE begins with the doctor's initial observations of the patient, typically during the process of taking a history. The how a patient interacts and behaves in front of the examiner can reveal something about the root of the mental disorder. This includes the dishevelled appearance of a depressed patient, or the provocative style of manic patients. It could also signal an absence of motivation or energy, like in a depressed person or an agitated person taking antipsychotic medication.
If a psychiatric test is conducted it is best to do it when the patient is relaxed and cooperative. It is a stressful and uncomfortable experience for both the patient and the examiner and it is crucial to present a positive impression. The MSE should be a relatively short part of the overall intake assessment and the results should be carefully evaluated in conjunction with findings from other sources like laboratory tests or imaging studies.
The MSE is less structured than the physical exam and most of the information is gathered by the doctor during the history-taking process. A thorough MSE will include descriptions of behavior and appearance as also alertness and focus as well as speech and motor activity such as mood and affect, perception and thought and attitude, as well as awareness. It should also include a detailed assessment of higher cognitive functions like parietal lobe function (pictorial construction and discrimination between right-left and left, localization of objects in space) and frontal lobe executive or diffuse cerebral cortical functions (judgment, abstract reasoning memory).
It is essential that the MSE be considered as part of a full intake evaluation and that doctors interpret the results with sensitivity and care. A thorough MSE can reveal a wide spectrum of abnormalities, which includes some that are specific to psychiatric disorders, however, it should be considered as a single data point in the overall history of the patient and is of limited clinical value on its own.
Assessing Thought Content
The largest section of the MSE is the thought content. It should contain information on delusional thoughts (thoughts that aren't true) like persecutory or grandiose ideas hallucinations (hearing things or seeing things that other people cannot) Preoccupations (such as worries or obsessions) and suicidal thoughts. These questions should be directly asked. The severity and the extent of the pathological thinking should 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).
The thought process is the coherence, logic, and relevance of the client's responses to MSE interviewer's questions. The doctor will also be able to determine if the thought process is unorganized or goal-oriented, and also when it flits from one topic to the next without making a clear connection. Disorganized, tangential and circumstantial connections are thought processes that can be indicators of mental health issues such as mania, schizophrenia and bipolar disorder.
Psychologists and neuropsychologists also evaluate the client's focus on task and capacity to store information in short-term memory. This can be assessed by self-reports, examiner observation or tests that are brief like counting backwards starting at 100 and then multiplying it by sevens. They can also assess the client's coping strategies and cognitive performance that is measured through direct questions and observations.
During the MSE psychologists will be observing the client's body language and facial expressions to determine if they seem aggressive or withdrawn. They also observe the client's agitation or fidgeting to determine if they're nervous or anxious. Psychologists often use the MSE in combination with other assessments and tests to establish a diagnosis and formulate a treatment plan. Psychologists are also trained to determine the signs that a client's behavior may be consistent with a particular mental illness or due to a different cause like substance abuse, an injury or medication side effect. This is essential in determining the best treatment and follow-up.
Evaluation of Mood, Anxiety and Stress
We all have tough times however, when these issues start to interfere with relationships, daily tasks and even the ability to sleep, it could be time to schedule a psychiatric assessment. Also known as a psych eval, this mental health test is usually performed by a psychiatrist or physician. It can be difficult, and you'll need to provide a wealth of personal information. It's important to remember that your doctor wants to gather all the information so they read more can come up with a valid diagnosis and suggest the appropriate treatment for you.
A psychiatric examination will consist of a review and physical examination of your medical history. This is to ensure that your symptoms aren't caused by a physical problem such as a thyroid disorder or an illness of the nervous system.
In addition your psychiatrist will also ask you about any other psychiatric or medical issues you've faced in the past and if you're taking any medication currently. If a patient is incapable of providing a full background due to their mental health it is crucial that their caregivers and family members are able to respond to the physician's questions. This is not a breach of confidentiality, and it allows the doctor to gather more details than he would in a face-toface interview.
During the psychiatric examination, the physician will assess the patient's emotional state by paying attention to their tone of voice and body language. They will also look at their thoughts to see if they are goal-directed and related. For example, the doctor will look at the ability of the patient to concentrate during the interview and whether they are able to easily switch between ideas. This is an important part of the examination, as patients who are either psychotic or manic might not be able to think clearly or quickly change their focus.
A psychiatric evaluation is usually the first step to get the care you require. Despite the stigma associated with mental illness, it's imperative that anyone who suspects they're suffering from the symptoms of a mental disorder seek an evaluation. Don't let fear or anxiety prevent you from seeking help because it could have serious and life-threatening consequences for yourself and the people who are around you.