A Full Psychiatric Assessment
A psychiatric examination is the first step towards getting proper mental care. The psychiatrist will ask you a number of questions about your work and personal life, the causes of stress, any major traumatic experiences you have experienced, and whether you've had substance or alcohol-related issues.
Background and Histories
A complete psychiatric assessment or psych eval is typically a multi-disciplinary exercise in hospital settings that involves psychiatric nurses, psychologists, occupational therapists and social workers. However, the psychiatrist plays the lead role in taking a detailed medical history and conducting an examination of mental health. The information is gathered through direct observation, the person being assessed and their carers and also through specific psychological tests.
The doctor will inquire with the patient about their symptoms and what they have been doing in the past few weeks, months, and years. They will also want to know about family and personal health. This information will help the doctor to know what is causing the symptoms and if they're caused by a different condition.
During this phase the psychiatrist will inquire about your medical background to determine if you have a family history of anxiety, depression, or other mental disorders. They will also ask whether there are any physical issues such as heart disease or diabetes, and what medications the patient is taking or was prescribed.
The psychiatrist will also be aware of any current symptoms and the length of time they have been present. They will also inquire about the person's lifestyle, including their job and their home environment. They will also talk about previous treatment and the level of adherence. Carers and families often share information the patient hasn't told them. This is done in a way of respect for confidentiality and doesn't violate their privacy rights.
Depending on the severity of symptoms, a number of additional tests and examinations could be required. These could include laboratory tests, blood pressure readings or electroencephalography (EEG), which measures brain activity. They may also use IQ test, which evaluates cognitive ability. They can test spatial abilities, concentration, memory and communication abilities.
It is crucial that all psychiatric evaluations are conducted by trained and skilled professionals. This will ensure the diagnosis is accurate and that the patient receives a treatment plan that is best suited to their needs.
Mental Status Test
The mental status exam (MSE) can be a painful experience for both the physician as well as the patient. It is an "snapshot" of the patient at a particular moment, and is useful to describe the patient's behavior and thoughts at that time. The MSE can also be useful in demonstrating how a patient's state mind changes over time. For instance, it can show the transition from depression to manic episode.
The MSE begins when the physician makes the first observations of the patient. This is typically done during the taking of the history. The way a patient interacts and behaves in front of the examiner can reveal something about the root of the mental disorder. This can be the case with the sloppy appearance of a depressed patient, or the provocative style of manic patients. It could also be a sign of a lack of motivation or effort in the person who is depressed or on antipsychotic medication.
If a psychiatric exam is performed it is best 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 important to leave a good impression. The MSE should be only an element of the overall intake evaluation. Its results must be carefully compared with other results, such as imaging studies or laboratory tests.
Like the physical exam it is the MSE is not as well suited to a structured approach, and most of it is determined by the physician's unstructured observations during the taking full psychiatric assessment of a history. Nevertheless, a detailed MSE should include descriptions of general appearance and behavior, alertness and attention in speech and motor activities mood and affect, thought and perception, attitude and understanding. It should also contain a comprehensive evaluation of higher cognitive abilities such as parietal lobe functions (pictorial construction, right-left discrimination, the localization of objects in space) and frontal lobe executive or diffuse cerebral cortical functions (judgment, abstract reasoning, memory).
It is important that the MSE be considered in the context of a full intake evaluation, and that physicians interpret results with care and sensitivity. A thorough MSE can reveal a wide range of abnormalities, including some that are specific to psychiatric disorders, but it must be viewed as a single point of data in the overall history of the patient and is of little clinical value by itself.
Evaluation of Thought Content
The biggest portion of the MSE is the thought content. It should include information about delusional ideas (thoughts which are not true) like grandiose or persecutory idea; hallucinations, (hearing things or seeing things that others cannot) Preoccupations (such as obsessions or worries); and suicidal thinking. These questions should be clearly asked. The intensity and extent of the psychopathic thinking needs to be described. Also whether or not they are in line with the mood (e.g. a patient who is depressed hearing voices that are angry or encouraging them to kill themselves, versus hallucinations that are peaceful and calm).
Thought process is the logic, relevance, coherence and flow of the client's thinking as they respond to the questions of the examiner during the MSE interview. 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 bipolar disorder, schizophrenia, and mania are often characterized by tangential, disorganized, and circumstantial thought processes.
Psychologists and neuropsychologists also test the client's attentional concentration and capacity to hold information in short-term memory. This can be measured by self-reports, examiner observation or brief tests like counting backwards beginning at 100 and multiplying it by sevens. They also evaluate the client's coping mechanisms and cognitive functioning, which is assessed through direct questions and observations.
During the MSE psychologists will be observing the client's facial expressions and body language to determine if they appear anxious or withdrawn. They also look at the client's nervousness or fidgeting to determine if they are anxious and fearful. Psychologists frequently use the MSE in combination with other assessments and tests to make a diagnosis and formulate an appropriate treatment plan. Psychologists are trained to determine whether a person's behavior is due to a mental disorder or caused by a different cause such as alcohol abuse, an accident or a medication side result. This information is crucial to determining the best treatment option and follow-up.
Assessment of Mood and Anxiety
Everyone experiences tough times however, when these issues start to interfere with relationships, daily activities and even the ability to sleep, it may be time to schedule a mental health assessment. This test for mental health is also known as "psych evaluation" and is typically conducted by a psychiatrist or a doctor. The procedure can be a bit daunting and usually there's plenty of information you'll need to disclose. It's important to remember that your psychiatrist wants to gather all the relevant information so that they can make a correct diagnosis and suggest the appropriate treatment for you.
A psychiatric evaluation will include an examination of your prior medical history and a physical examination. This is to ensure that your symptoms are not caused by a physical condition such as a thyroid disorder or an illness of the nervous system.
Your psychiatrist will also ask about any psychiatric or medical conditions and if you are currently taking any medication. If a patient is not able to provide a medical account due to their mental state it is crucial that their caregivers and family members are able to respond to the questions of the doctor. This isn't a violation of confidentiality and allows the doctor to get more complete information than would be possible in a face-to-face interview.
In the psychiatric consultation the doctor will evaluate the emotional state of the patient by watching their body speech and tone of voice. They will also look at their thoughts to see if they are goal-directed and connected. For example, the doctor will examine how the patient is able to focus during the interview and how easily they switch between various ideas. This is an important part of the assessment, as patients who are either psychotic or manic might not be able to think clearly or rapidly shift their focus.
A psychiatric evaluation is usually the first step to get the treatment you require. Despite the stigma associated with mental illness, it's crucial that anyone who suspects suffering from symptoms of mental illness seek an evaluation. Don't let fear or anxiety stop you from seeking help. It could have dire consequences for the people around you as well as for yourself.