General Psychiatric Assessment
There are numerous challenges in conducting psychiatric assessments in general medical settings. They include privacy concerns as well as ward rounds and assessments by other specialties, protected meal times and planned visits from family members.
It can be difficult to determine the outcome in this situation, due to particular difficulties for outcomes specific to diseases and patient and referrer satisfaction ratings.
Medical History
The first step in a general psychiatric evaluation is to understand the patient's medical background. This includes information about the patient's current health, any medications they are taking and any major past medical conditions that may have impacted their health and well-being. This information can help the physician determine which psychological tests are appropriate and how many visits may be required before determining a diagnose.
This procedure can be a challenge to complete in medical wards because of the limited space and interruptions from visits to wards, assessments from other specialties or allied health professionals as well as protected mealtimes. It is crucial to find an area that is quiet to conduct the assessment and to make an appointment that does not conflict with any of these activities. Inquiring about the referrer's specific concerns will help determine what type of assessment is required for psychiatric disorders.
When carrying out psychiatric assessments on medical wards of general hospitals it is important to keep in mind that physical health problems the patient is suffering from can influence or even overshadow their psychiatric symptoms and behavior. This is a common problem that is referred to as diagnostic shadowing and is extremely difficult to avoid. If a patient is admitted with delirium but has an diagnosis of dementia in their medical records, it could be tempting to 'overshadow the delirium' and assume that it is the result of their mental illness. This is rather than performing a complete screen for delirium to rule out treatable causes such as stroke.
It is important that the psychiatrist assessing the patient attempts to establish a connection between the physical and psychiatric issues of the patient and to solicit complaints or concerns from the patient regarding their treatment, their treatment or how their condition is being managed. Reference Osborn & Warner (1998) recommends the most basic approach to accomplishing this. However, it could be difficult to implement in the real world.
Family History
The psychiatrist will inquire about your family history to determine if there's an issue with mental health within your family. They'll also want be aware of any past traumas or abuse you've had and your current social circumstances (including relationships, work and whether you have support at home). You may be asked about your beliefs in religion, your dreams and ambitions. The psychiatrist will make an assessment, and then create a treatment plan that is suited to your needs.
The psychiatrist should also check physical symptoms. They will examine their blood pressure, listen and feel the lungs and heart and examine for any other medical conditions that could be causing the psychiatric sign.
It is usually beneficial for the psychiatrist to get an entire physical exam from the general practitioner of the patient but it's not always possible particularly for those who are seriously ill and those who are inpatients on psychiatric wards. Patients on these wards might have only sporadic face-toface 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 needs are addressed.
Psychiatrists should also be able to comprehend why a person was referred to them and what they hope to accomplish through their psychiatric evaluation. They must be able to read medical letters, review reports of tests and communicate effectively with the person's medical team to determine the best treatment or medication for the patient.
The medical history is an essential component of any psychiatric evaluation and must include the patient's personal psychiatric diagnosis and past treatment, as well as information regarding their alcohol and drug use. It is also essential to obtain a complete family history, if assessment of psychiatric patient possible, in order to establish the likelihood of developing certain disorders, such as bipolar disorder, which is known to run in families. It is useful to use brief screens that record the lifetime psychiatric information of informants and their first-degree relatives, but it is equally crucial to have an entire family psychiatric history.
Signs and symptoms
During the psychiatric examination 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, as well as any other issues that might be relevant. It may be uncomfortable at times, but you need to answer honestly and completely to ensure that you receive a correct diagnosis.
If you're suffering from mental health problems, such as depression or anxiety, it is important to seek a psychiatric examination to determine whether or not you require treatment. It is normal to have periods of depression and stress but should they last for more than several days or impact your daily activities, then you might require treatment.
In addition to discussing your symptoms, your psychiatrist will also ask about any other issues that might be impacting you, such as problems at work or with your family, or abuse of substances. They will also ask about your physical health, sleeping habits, and if you've tried other approaches to manage your symptoms.
Your psychiatrist may also ask you questions about your past experiences with mental illness, and they may use standardized assessment tools or psychological tests to gain more insight into your situation. These tests could include personality tests, questionnaires or cognitive tests that measure your level of distress.
If the psychiatric assessment confirms that you are experiencing psychotic symptoms that are caused by hallucinations, delusions or hallucinations that are significant deviations from reality as a consensual entity, the psychiatrist will need to perform a more in-depth exam and may have to admit you to hospital for observation. In such cases you'll need be evaluated by a different psychiatrist before returning home.
Greater Lowell Psychiatric Associates will give you the support and care you need. The team of friendly and knowledgeable professionals is dedicated to providing you with the information you require about the diagnosis you have received and possible treatment options. You can book a psychiatric examination online or over the phone today.
Psychological Tests
An essential part of a psychological evaluation is the use of a variety of tests. Psychological tests are written or verbal assessments designed to measure non-observed elements. 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, like depression or anxiety. Psychological testing is typically done by a psychologist who has been trained. The patient must adhere to certain guidelines to obtain accurate results.
Psychological assessments can differ in regards to the number and types of psychological tests that are that are administered, based on the symptoms of an individual. A general psychiatric examination could be short, such as the Mini-Mental State Examination (MSE) or more detailed and time-consuming, such as the Montreal Cognitive Assessment. Neuropsychological tests that are in-depth can be used to determine the presence of brain injuries, concussions or other neurological disorders.
All types of psychiatric examinations provide a snapshot into the patient's emotional and psychological functioning. In hospitals doctors, psychologists, and sometimes psychiatrists conduct these assessments to determine a patient's mood, emotional reactivity and cognitive capabilities. They are also conducted by private therapists in their offices to gather information to develop a treatment plan and to determine if a patient would benefit from medication or other types of therapy.
Intelligence & Achievement Tests are examples of psychological assessments. These tests measure cognitive performance (often known as IQ) in comparison to a normal group. Other tests are designed to evaluate the ability to perform tasks, like an assessment of memory or an assessment of word association. Psychologists are the only experts who have the training and experience to conduct and interpret psychological tests.
The aim of a psychiatric examination is to connect the patient with a physician who can provide treatment and management. When the examination is completed the doctor will inform the patient of the diagnosis and the relationship to their presenting symptoms. The doctor will also speak about the prognosis. This is how a diagnosis is expected to progress in time.