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A Full Psychiatric Assessment A psychiatric examination is the first step towards getting proper mental care. The psychiatrist will ask you a lot of questions regarding your work and home life, sources of stress, any major traumatic experiences you have endured, and whether you have experienced any 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 psychologists, occupational therapists, and social workers. The psychiatrist is the one who compiles a detailed medical record and conducts a mental assessment. The information is gathered through direct observation, the person being assessed and their 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 months, weeks, and years. They will also want to know about their personal and family health. This information will help the doctor determine the cause of symptoms and if they are the result another illness. In this stage the psychiatrist will inquire about your medical background to determine if you have an ancestral history of anxiety, depression, or other mental disorders. They will also want to find out if the patient suffers from any physical issues, such as diabetes or heart disease and the medications they are taking or have been prescribed in the past. In addition the psychiatrist will make a note of the current symptoms and the length of time they've been experiencing them for. They will also ask about the person's life such as their job and their home. They will also discuss prior treatment and the degree of compliance. Carers and families often share information the patient hasn't told them. This is done out of respect for confidentiality and does not violate their privacy rights. Based on the severity of symptoms, a variety of other tests and observations may be required. These could include laboratory tests, blood pressure readings or electroencephalography (EEG), which measures brain activity. They might also use IQ tests, which measure cognitive ability. These can test spatial skills as well as concentration, memory and communication skills. All psychiatric tests should be performed by professionals who are experienced and qualified. This will ensure that the diagnosis and treatment plan are correct. Mental Status Examining Mental status examinations (MSEs) can be a terrifying experience for both the patient and the physician. It is an “snapshot” which is an image of the patient at an exact moment. It can be used to record the patient's thoughts, behavior and attitudes at that specific moment. The MSE can also prove useful in describing how a patient's mental state changes over time, such as from depression to mania. The MSE starts when the doctor begins to make the first observations about the patient. This is typically done during the taking of the history. How a patient interacts with the examiner and with their surroundings can reveal important information about the underlying psychiatric disturbance. This includes the discolored appearance of a depressed person or the flamboyant style of manic patients. It could also be a sign of an absence of motivation or effort such as in a depressed individual or an agitated person taking antipsychotic medication. It is ideal to conduct a psychiatric test when the patient is at ease, cooperative and willing. It can be a challenging and uncomfortable experience for the patient and the examiner, and it is essential to present a positive impression. The MSE should be only an element of the overall intake assessment. Its results should also be carefully compared with the results from other sources such as imaging studies or tests in the laboratory. As with the physical exam as well, the MSE does not lend itself to a structured approach and the majority of it is gathered through the physician's observations during the taking of a history. Nevertheless, a detailed MSE should include descriptions of the general appearance and behavior, alertness and attention in speech and motor activities mood and affect, thinking and perception as well as attitude and insight. It should also include a detailed evaluation of higher cognitive functions such as parietal-lobe functions (pictorial construction, right-left discrimination, the localization of objects in space) and frontal lobe executive or diffuse cortical functions (judgment, abstract reasoning memory). It is important that the MSE be considered in the context of a thorough intake evaluation and that doctors interpret results with care and sensitivity. A thorough MSE can reveal a wide spectrum of abnormalities, which includes many 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 on its own. Reviewing the Content of Thoughts The largest section of the MSE is the thought content. It should include information on delusional thoughts (thoughts that aren't true) – such a grandiose or persecutory 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 extent and intensity of the psychotic thoughts must be outlined, along with whether they are mood-congruent or incongruous (e.g. A depressed patient may hear voices that are angry and urge them to commit suicide, as opposed to calm and peaceful hallucinations. Thought process refers to the logic, relevance, coherence and flow of the client's thinking as they respond to the examiner's questions during the MSE interview. Doctors also look for signs that the thought process is disorganized or goal-directed and if it flits from one topic to another without any obvious connection between them. Mental health disorders like bipolar disorder, schizophrenia and mania can be indicated by disorganized, tangential, and circumstantial thought processes. Psychologists and neuropsychologists assess the capacity of the client to pay on a single subject and then hold it in their memory. This can be measured through observer observations, self-report or brief tests such as counting backwards from 100 by 7s. They also evaluate the client’s coping mechanisms and cognitive performance by assessing it through direct questions and observations. During the MSE, psychologists observe the client's facial expressions as well as body language to determine if they seem withdrawn or aggressive. They also observe the client's nervousness or fidgeting to determine if they're nervous or anxious. Psychologists use the MSE together with other tests and assessments to diagnose and design a treatment program. Psychologists are trained to identify the severity of a client's behavior caused by a mental illness or caused by a different cause such as substance abuse, an accident, or a medication adverse effect. This is essential in determining the best treatment option and follow-up. Assessment of Mood, Anxiety and Stress It's normal to experience difficult times. But when these difficulties start to affect relationships, daily tasks, and even sleep, it might be time to make an appointment for a psychiatric assessment. Also called a psych eval and a mental health check, this test is usually performed by a psychiatrist or physician. The procedure can be a bit daunting and you'll usually have lots of information you'll have to share. However, it's important to understand that your therapist is working to gather all the facts they need so they can make an accurate diagnosis and recommend the best treatment for you. A psychiatric examination will consist of an examination of your prior medical history and physical examination. This is to ensure that there are no physical issues that could be causing your symptoms such as thyroid issues or a neurologic condition. Your psychiatrist will also ask about any past psychiatric and medical problems and whether you are currently taking any medications. If the patient is not able to give an account of their mental state it's important that their family and caregivers can answer the questions. psychiatric assessment report is not an invasion of privacy, and it allows the doctor to obtain more information than he could during a face-toface conversation. In the psychiatric consultation the doctor will evaluate the patient's emotional state by paying attention to their voice tone and body language. They will also assess their thoughts to determine if they are goal-directed and related. The doctor will also examine the way in which the patient can focus and switch between ideas during the interview. This is a crucial aspect of the evaluation, since those who are either psychotic or manic might not be able to concentrate or quickly change their focus. A psychiatric assessment is often the first step to get the care you require. It is essential that anyone who suspects that they are suffering from the symptoms of mental illness should seek an evaluation. Don't let your fear or anxiety stop you from seeking help. It could have a serious impact on you and others around.