General Psychiatric Assessment
The challenges of carrying out mental health assessments in general medical settings are many. These include problems with privacy, ward rounds and assessments by other specialties, protected meals and scheduled visits from family members.
In this way it can be a challenge to determine the impact of outcomes, especially when it comes to disease-specific outcomes.
Medical History
The first step of a general psychiatric evaluation is to understand the medical background of the patient. This will include information about the patient's current health, any medications they are taking and any significant past medical problems that could affect their current health and well-being. This information will help the professional decide which psychological tests are appropriate and the number of appointments they may need to make before making the diagnosis.
This is often a challenge to complete on medical wards due to the limited space available and interruptions during the ward's rounds, examinations by other specialties and health experts, protected mealtimes, and scheduled visitors. It is worth trying to schedule an appointment time that is not in conflict with any of these activities and find a quiet space for the examination to be conducted. It is also beneficial to ask the person who refers you what their concerns are so that you can determine precisely what type of psychiatric evaluation is required.
It is crucial to remember that physical health issues may affect or even overshadow symptoms of psychiatric illness. This is a frequent issue that is known as diagnostic overshadowing and is extremely difficult to avoid. For instance when the patient was admitted for a delirium and they have a prior diagnosis of dementia on their medical record then it is tempting to "shadow" the delirium by assuming it is caused by their existing mental illness instead of conduct a complete screening for delirium to rule out treatable causes such as stroke.
It is therefore important that the psychiatrist who is conducting the assessment of the patient seeks to establish the relationship between the patient's physical and psychiatric issues and to inquire about any concerns or complaints that the patient has about their treatment, care or the manner in which their health condition is being managed. The basic model that is suggested in Reference Osborn and Warner (1998) is a simple schema for achieving this, but it can be a challenge to implement this in practice.
Family History
The psychiatrist will inquire about your family history to see whether there are any mental health issues within your family. They'll also inquire about any traumas you've experienced or abuse, and your current status in the social world (including your work, relationships, and if you have support from home). You might be asked about your religion as well as your goals and dreams. The psychiatrist will then make an assessment and create a treatment plan that will meet your requirements.
Physical symptoms are also important and it is essential that the psychiatrist checks these too. They will examine their blood pressure, listen and feel the lungs and heart as well as examine for any other medical conditions that could be causing the psychiatric symptom.
It is usually beneficial for the psychiatrist to get an all-encompassing physical from the general practitioner of the patient but this isn't always possible especially for patients who are very ill or inpatients on psychiatric hospitals. The patients on these wards may have only sporadic face-toface contact with psychiatrists, or perhaps none at all. In these instances it is crucial that the psychiatrist's nurses or care coordinators play a proactive role in ensuring the physical health requirements of patients are met.
Psychiatrists should also understand why a person has been referred and what they are hoping to initial psychiatric assessment achieve with their psychiatric evaluation. They must be able interpret medical letters, examine the results of tests and communicate effectively with the person's medical team to coordinate any medication or treatment.
The medical history is an essential element of any psychiatric examination. It should include details about the patient's psychiatric diagnosis and treatment history as well as any drug and alcohol usage. If it is possible, it is important to collect an entire family history to assess the risk of developing certain disorders such as bipolar disorder. It is useful to use brief screens that gather lifetime psychiatric data on informants and their first-degree relatives but it is equally important to obtain an entire family psychiatric history.
Symptoms
During the psychiatric assessment the doctor will ask you about your symptoms and how they have affected your life. Your psychiatrist will also ask you about your family history and other issues that might be relevant. The interview can feel invasive at times, but it is important to answer honestly and fully to ensure that a correct diagnosis can be determined.
If you are experiencing mental health issues like depression or anxiety it is crucial to get a psychiatric evaluation to determine if you require treatment. It is normal to have periods of depression and stress but if they last more than a few days or affect your daily functioning then you may require treatment.
Your doctor will inquire about your symptoms as well as any other issues impacting you, like family or work-related issues or abuse of substances. They will also inquire about your physical health, your sleeping habits and whether or not you've tried any other ways to help with your symptoms.
Your psychiatrist could also inquire about your past experiences of mental illness. They could also employ standardized assessment tools, or psychological tests, to gain a better understanding of your current situation. These tests could include personality tests, questionnaires or cognitive tests that measure the level of stress you are experiencing.
If the psychiatric assessment shows that you are experiencing psychotic symptoms that are caused by hallucinations, delusions or hallucinations that are significant deviations from the reality of consensual, the psychiatrist will need to perform a more in-depth exam and may have to admit you to a hospital for observation. You will be required to undergo a second evaluation by a psychiatrist before you are allowed to go home.
Greater Lowell Psychiatric Associates will provide you with the assistance and care you need. The team of skilled and knowledgeable professionals are committed to providing you with the information you need about your diagnosis and treatment options. You can schedule your psychiatric exam via the internet or call us today.
Psychological tests
The use of a variety of tests is an essential part of a psycho-psychological assessment. Psychological tests are written or verbal evaluations designed to measure unobserved aspects. They are often used to assess a person's personality traits and emotional functioning. They can be used to determine the severity of a certain mental illness, for example, anxiety or depression. Psychological testing is typically conducted by a qualified psychologist and requires the patient to adhere to specific instructions to obtain accurate results.
Psychiatric assessment can vary in terms of the number and types of psychological tests that are that are administered, based on the symptoms of an individual. A general psychiatric examination may be short, such as the Mini-Mental State Examination, or in-depth and lengthy, like a Montreal Cognitive Assessment. Neuropsychological tests can be used to determine if there's a concussion or brain injury.
All kinds of psychiatric assessments help provide a snapshot of the patient's overall psychological and emotional state. They are performed by psychologists, doctors, and sometimes psychiatrists in the hospital setting to evaluate a person's present mood, emotional reactivity, and cognitive abilities. They are also performed by private therapists in their offices to gather data to develop a treatment plan and to determine if a patient could benefit from a medication or other kinds of therapy.
Some examples of psychological evaluations include intelligence & achievement tests which test certain types of cognitive functioning (often referred to as IQ) and performance in comparison to a standard group. Other tests are designed to assess the ability to complete tasks, like memory or word association test. Psychologists are the only experts with extensive training as well as experience conducting and interpreting psychological tests.
A psychiatric evaluation is designed to connect the patient with a medical professional who can offer treatment and management. After the exam is completed, the doctor will inform the patient of the diagnosis and how it is related to their present symptoms. The doctor will also talk about the prognosis. This is how a diagnosis can be likely to develop in time.