A Full Psychiatric Assessment
A psychiatric evaluation is the first step to receiving proper mental health care. The psychiatrist will ask you a number of questions about your work and personal life, the causes of stress, any significant traumas you've experienced, and if you have had any issues with alcohol or drugs.
Background and Histories
A full psychiatric examination, or psycheval, is a multidisciplinary process that is carried out in hospitals. It involves psychiatric nursing as well as occupational therapy, psychologists, and social workers. However, the psychiatrist plays the lead role in obtaining a thorough medical history and carrying out an examination of the mental state. This information can be gathered through direct observation, the person being assessed and their carers and also through specific psychological tests.
The doctor will ask the person about their symptoms and what they have been doing in the last few weeks, months, and years. They will also want to know about their personal and family health. This will help the doctor to determine what is the cause of the symptoms, and if they're due to a different issue.
In this phase an psychiatric doctor will inquire about your medical background to determine if there's a family history of anxiety, depression, or other mental disorders. They will also want to be aware of if the patient is suffering from any physical ailments like diabetes or heart disease and what medications they are taking or were prescribed in the past.
In addition the psychiatrist will make note of the present symptoms and how long they've been suffering for. They will also ask the person about their lifestyle, such as their job and home environment. They will also discuss the individual's prior treatment and the extent of their adherence to it. Carers and family members often share information that the patient hasn't shared with them. This is done in a way of respect for confidentiality and doesn't violate their right to privacy.
Based on the severity of the symptoms, a range of other tests and observations could be required. These could include laboratory tests, blood pressure readings or electroencephalography (EEG), which measures brain activity. They could also take IQ tests, which assess the ability to think. These tests test spatial abilities, concentration memory, memory, as well as communication skills.
All psychiatric tests should be conducted by a professional who are experienced and qualified. This will help ensure that the diagnosis is correct and that the patient receives a treatment program that best suits their needs.
Mental Status Examination
Mental status examinations (MSEs) can be a frightening experience for both the doctor and patient. It's an "snapshot" of the patient at a specific moment, and can be useful for describing the patient's behaviours and thoughts at the time. The MSE is also useful in describing how a patient's state of mind changes over time. For instance, it can show the transition from depression to manic episode.
The MSE begins with the physician's initial observations of the patient, typically during the process of taking a history. The how a patient interacts and behaves around the examiner can reveal a lot about the underlying mental disorder. This includes the dishevelled appearance of a depressed patient or provocative style of a manic patient. It can also be a sign of a lack of motivation or effort in someone who is depressed or taking antipsychotic medication.
If a psychiatric test is performed, it is best done when the patient is at ease and cooperative. Both the patient and the examiner might be uncomfortable during the interview. It is important to make the right impression. The MSE should only be an getting a psychiatric assessment element of the overall intake evaluation. Its results should also be carefully compared to other results such as imaging studies or tests in the laboratory.
As with the physical exam as well, the MSE is not as well suited to a structured approach, and much of it is obtained by the physician's unstructured observations during the history-taking. Nevertheless, a detailed MSE should include descriptions of the general appearance and behavior, alertness and attention, motor and speech activity, mood and affect, thought and perception as well as attitude and insight. It should also include a detailed evaluation of higher cognitive functions like parietal lobe function (pictorial construction and discrimination between right-left and left, the 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 physicians interpret results with care and sensitivity. A thorough MSE may reveal a variety of abnormalities including those that are specific to mental disorders. However, it should be viewed as a single data point in the patient's medical history and has no clinical value.
Evaluation of Thought Content
The most important part of the MSE is the thought content. It should include information on delusional thoughts (thoughts that are not real) that include persecutory or grandiose ideas hallucinations (hearing things or seeing things that other people cannot) Preoccupations (such as obsessions or worries) and suicidal thoughts. These questions should be asked directly. The intensity and extent of the psychotic thinking should be described. Also, whether or not they are in sync with the mood (e.g. a patient who is depressed hearing voices that are angry or urging 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 MSE interviewer's questions. The doctor will also be able to determine if the thought process is unorganized or goal-oriented, and if it jumps from one subject to the next without a clear connection. Mental health disorders like schizophrenia, bipolar disorder, and mania may be characterized by disorganized, tangential, and circumstantial thought processes.
Psychologists and neuropsychologists also evaluate the client's focus on task and capacity to hold information in short-term memory. This can be assessed by examiner observations, self-reports or short tests like counting backwards starting at 100 and multiplying it by sevens. They also can assess the client's coping strategies and cognitive performance by assessing it through direct questions and behavioral observations.
During the MSE psychologists observe the client's body language and facial expressions to determine if they appear aggressive or withdrawn. They also look at the client's fidgeting and restlessness to determine if they are anxious or fearful. Psychologists employ the MSE along with other tests and assessments to determine the cause and formulate a treatment program. Psychologists are also trained to recognize if the client's behavior is similar to a particular mental illness or is instead due to another cause such as substance abuse, an injury or an adverse reaction to medication. This is essential in finding the most effective treatment and follow-up.
Evaluation of Mood, Anxiety, and Stress
Everyone experiences tough times, but when those difficulties start to interfere with relationships, daily tasks and even one's ability to sleep, it may be time to schedule a psychiatric evaluation. Also called a psych eval and a mental health check, this examination is typically conducted by a psychiatrist or a doctor. It can be a bit daunting, and you'll be required to provide lots of personal information. It's important to remember that your therapist is looking to gather all the details so they can make a correct diagnosis and recommend the right treatment for you.
A psychiatric evaluation will consist of an examination and review of your medical history. This is to ensure that there aren't any physical issues that could be causing your symptoms like thyroid issues or a neurologic condition.
Your psychiatrist will also ask about any past psychiatric and medical issues and whether you are currently taking any medications. In cases where patients are incapable of providing a full background due to their mental state it is crucial that their family members and caregivers can answer the doctor's questions. This is not an invasion of privacy, and allows the doctor to gather more information than he could in a face-toface interview.
During the psychiatric interview, the physician will assess the patient's emotional state by observing their tone of voice and body language. They'll also evaluate their thoughts to determine if they're focused 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 different ideas. This is a crucial aspect of the assessment, as patients who are manic or psychotic may not be able to concentrate or swiftly shift their focus.
For many an evaluation for psychiatric issues is the first step to get the right treatment they require. Despite the stigma that surrounds mental illness, it's crucial that anyone who suspects they're suffering from the symptoms of a mental disorder seek an evaluation. Don't let your fear or anxiety prevent you from seeking help as it could have serious and life-threatening implications for you and others who are around you.