General Psychiatric Assessment
The difficulties of conducting psychiatric assessments in general medical settings are many. There are many issues to be faced, including privacy issues, ward rounds, assessments by other specialists, secured mealtimes and scheduled family visits.
It is also difficult to determine the outcome in this situation, due to particular challenges for specific outcomes related to disease and satisfaction of patients and referrers ratings.
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 condition as well as any medications they are taking and any significant past medical conditions that may have impacted their health and well-being. This information can also aid the doctor in determining what psychological tests are appropriate and how many appointments may be needed before making a diagnose.
This step is often difficult to complete on medical wards due the limited space available and interruptions during ward rounds, assessments by other specialties, allied health professionals, protected mealtimes and scheduled visitors. It is crucial to find a quiet place to conduct the assessment and to make an appointment that doesn't conflict with any of these activities. It is also useful to ask the person who refers you what their concerns are so that you can identify precisely what type of psychiatric evaluation is required.
When carrying out psychiatric assessments on the medical wards of general hospitals it is important to keep in mind that physical health issues that patients present with may influence or even overshadow their psychiatric symptoms and behaviour. Overshadowing by diagnosis is a common problem and is difficult to avoid. For instance the case where an individual has been admitted to a delirium hospital and has a pre-existing diagnosis of dementia on their medical records then it is tempting to "shadow" the delirium and assume that it is caused by an existing mental illness rather than perform a full delirium screen to rule out causes that are treatable such as stroke.
It is important that the psychiatrist who is assessing the patient is able to establish a link between the psychiatric and physical concerns of the patient and to solicit complaints or concerns from the patient regarding their treatment, treatment or how their condition is handled. The basic model recommended in Reference Osborn and Warner (1998) is an easy way to accomplish this, however it can be difficult to implement it in real life.
Family History
The psychiatrist will ask about your family history to determine if there are any mental health problems within your family. They will also want to be aware of any past incidents of abuse or trauma you've experienced and your current situation in the social world (including relationships, work and whether you have support at home). You might be asked about your beliefs in religion, your dreams and ambitions. The psychiatrist will provide an assessment, and then design a treatment plan that is suited to your needs.
The psychiatrist should also check physical symptoms. They will check the patient's blood pressure and listen to the heart and lungs and examine for any other medical conditions that could be causing or aggravate the psychiatric symptoms.
It is helpful for psychiatrists to get a complete physical from the doctor who is treating the patient however this might not be possible, particularly with those who are sick or inpatients in psychiatric units. Those on these wards may only have sporadic face-to-face contact with psychiatrists or none at all. In such cases it is essential that psychiatric nurses and care coordinators play a prominent role in ensuring that patients' physical health issues are addressed.
Psychiatrists should also be able understand why a person is being evaluated and what they are hoping to achieve through their psychiatric examination. They should be competent in interpreting medical letters and investigate reports of tests from an GP or other health professional. They must communicate effectively with the medical team of the patient about what investigations have been completed so that any medication or other treatments can be coordinated.
The medical history is an essential aspect of any psychiatric examination and should include the patient's diagnosis of psychiatric illness and treatment history, as well as information regarding their alcohol and drug usage. If possible, it is important to collect an entire family history to assess the risk of certain disorders such as bipolar disorder. Screens to collect life-long psychopathological information from informants and first-degree relatives can be helpful however, there is a merit in having a complete family psychiatric history in addition.
Symptoms
During the psychiatric examination, your doctor may inquire about your symptoms and how they affect your life. Your psychiatrist will also ask you about your family history and other issues that may be relevant. It may be uncomfortable at times, but you need to be honest and complete to ensure that you receive a correct diagnosis.
If you're experiencing mental health issues, such as depression or anxiety it is essential to seek a psychiatric examination to determine if you require treatment. While it is normal to have periods of stress or low mood occasionally however, if these symptoms last for more than two weeks and interfere with your daily life, it is likely that you require treatment.
Your doctor will inquire about your symptoms and any other issues affecting you, such as family or work-related issues or addiction issues. They will also inquire about your physical health, sleeping habits, and whether or not you've tried any other strategies to treat your symptoms.
Your psychiatrist will also ask you questions about your past experiences with mental illness, and they may use standardized assessment tools or psychological tests to gain understanding of your situation. These tests can include personality assessments, questionnaires or cognitive tests that assess the level of stress you are experiencing.
If the psychiatric assessment indicates that you are suffering from psychotic symptoms that are caused by hallucinations, delusions or hallucinations that are a significant departure from the reality of consensual, the psychiatrist will need to conduct a more thorough examination and may need to admit you to a hospital for observation. In these cases, you will need to be evaluated by a different psychiatrist before you can return home.
If you are seeking an evaluation of your psychiatric condition, Greater Lowell Psychiatric Associates can provide you with the care and support you need. The team of helpful and knowledgeable professionals is dedicated to giving you the information you need about your diagnosis and treatment options. You can schedule a psychiatric assessment on the internet or by phone today.
Psychological Tests
The use of various tests is an essential part of a psycho-psychological assessment. Psychological tests are either written or verbal assessments that are designed to test unobserved constructs. They are used to evaluate the person's emotional health and personality traits. They can be used to determine a person's mental illness' severity, such as depression or anxiety. Psychological testing is typically conducted by an experienced psychologist who has been trained. The patient must follow certain instructions to get accurate results.
Psychiatric assessment can vary in regards to the number and types of psychological tests that are administered, based on an individual's symptoms. A general psychiatric test could be short, such as the Mini-Mental State Examination (MSE) or more thorough and time-consuming tests, such as a Montreal Cognitive Assessment. Neuropsychological testing can be used to determine if there is a brain injury or concussion.
All types of psychiatric evaluations can provide a here picture of the patient's psychological and emotional functioning. In hospitals doctors, psychologists, and psychiatrists may conduct these evaluations to assess a patient's mood emotional reactivity, cognitive abilities. They are also conducted by private therapists at their offices to gather data to develop a treatment plan and to determine if a patient could benefit from medication or other types of therapy.
Intelligence and Achievement Tests are an example of psychological evaluations. These tests measure cognitive performance (often called IQ) in contrast to a normative group. Other tests are designed to assess the ability to perform tasks, like a memory test or a word association test. Psychologists are the only experts who have the training and experience to conduct and interpret psychological tests.
The goal of a psychiatric exam is to connect the patient with a doctor who can offer treatment and management. When the examination is completed the doctor will inform the patient of the diagnosis and how it is related to their present symptoms. The doctor will also discuss the prognosis, which is the way in which a specific diagnosis is expected to change over time.