General Psychiatric Assessment
There are many challenges to performing psychiatric examinations in general medical settings. There are numerous challenges such as privacy concerns, ward rounds, assessments by other specialists, secured mealtimes and planned family visits.
It can also be difficult to determine the outcome in this situation, due to particular challenges for specific outcomes related to disease and patient and referrer satisfaction ratings.
Medical History
The first step of a general psychiatric evaluation is to understand the medical background of the patient. This will include details of their current health and any medication they are taking, as well as any significant previous medical problems that could have affected their health and wellbeing. This information will aid the doctor in determining what psychological tests are appropriate and how many appointments may be necessary prior to making diagnosis.
This process can be difficult to complete in medical wards because of the limited space and interruptions from ward rounds, assessments from other specialties or allied health professionals as well as meals that are protected. It is important to schedule an appointment time that doesn't clash with any of these activities and find somewhere quiet for the assessment to take place. It is also helpful to ask the referrer what their specific concerns are, so that you can determine exactly what kind of psychiatric examination is required.
When conducting psychiatric examinations on the medical wards in general hospitals, it is important to remember that the physical health problems a patient presents with can affect or even obscure their psychiatric symptoms and behavior. This is a frequent issue that is referred to as diagnostic overshadowing and can be very difficult to avoid. For instance the case where an individual has been admitted to hospital for delirium and they have a pre-existing diagnosis of dementia on their medical record it can be tempting to 'overshadow' the delirium by assuming that it is caused by an mental illness, rather than carry out a full screening for delirium to rule out treatable causes such as stroke.
It is crucial that the psychiatrist who is assessing the patient tries to establish a link between the psychiatric and physical concerns of the patient and to elicit concerns or complaints from the patient regarding their treatment, care or how their health condition is handled. Reference Osborn and Warner (1998) suggests an approach to achieve this. However, it could be difficult to implement in practice.
Family History
The psychiatrist will ask you about your family history to determine if there's a mental health problem within your family. They'll also want to be aware of any past experiences of abuse or trauma and your current social circumstances (including relationships, work and whether you have a support system at home). You might be asked questions about your beliefs in religion and about your ambitions and goals. The psychiatrist will then make an assessment and formulate a treatment plan that will fit your needs.
Physical symptoms are equally important and it is essential that the psychiatrist evaluate these as well. They will test their blood pressure, listen and feel the heart and lungs as well as examine for any other medical conditions that may be causing the psychiatric symptom.
It is helpful for a psychiatrist to receive a complete physical from the patient's doctor, but this might not be feasible, particularly for people who are very sick or inpatients in psychiatric units. Those on these wards may have only sporadic face-toface contact with psychiatrists, or perhaps none at all. In such cases it is crucial that psychiatric nurses or care coordinators take an active role in ensuring that these patients' physical health concerns are met.
Psychiatrists must also understand why a person is being referred to them and what they expect to achieve with their psychiatric evaluation. They should be able to interpret medical letters, examine the results of tests and communicate effectively with a person's medical team to manage any medication or treatment.
The medical history is a key component of any psychiatric evaluation, and this must include the patient's psychiatric diagnosis and past treatment and also details about their alcohol and drug usage. If you can, it's important to obtain an entire family history to assess the risk of certain disorders such as bipolar disorder. Screens that are brief to gather lifetime psychopathological information from informants and first-degree relatives can be helpful but there is the benefit of obtaining a complete family history of psychiatric issues as well.
Symptoms
During the psychiatric examination, your doctor will ask you about your symptoms and how they have affected your life. Your psychiatrist will also inquire about any pertinent issues like your family history. The interview can feel invasive at times, but it's important to answer honestly and completely so that an accurate diagnosis can be made.
If you are suffering from mental health problems, such as anxiety or depression, it is important to get a psychiatric evaluation to determine whether or not you need treatment. While it is normal to be afflicted with stress or low mood at times but if the symptoms last for more than two weeks and interfere with your daily activities it is likely you need treatment.
In addition to discussing your symptoms, your psychiatrist will also inquire about any other issues that might be impacting you, such as issues with work and family or substance abuse. They will also ask you about your physical health, your sleeping habits, and whether or not you have tried any other ways to help with your symptoms.
Your psychiatrist may also ask you about your experiences with mental illness. They may also use assessments that are standardised or psychological tests to gain a better understanding of your situation. These tests can include personality assessments, questionnaires or cognitive tests that measure the level of stress you are experiencing.
If your psychiatric examination indicates that you are suffering from psychotic symptoms, for example hallucinations or delusions that are a significant departure from what is thought to be real, then the psychiatrist may need to conduct a thorough examination and then admit you to the hospital for observation. In such cases you'll need be evaluated by a different psychiatrist before you can return home.
Greater Lowell Psychiatric Associates will provide you with the support and care you need. The team of experienced and friendly professionals are committed to providing you with the information you need about your diagnosis and treatment options. You can book a psychiatric examination via the internet or by calling today.
Psychological tests
An important part of a psychological assessment involves the use of different tests. Psychological tests are written or verbal assessments that are designed to test unobserved constructs. They are commonly used to determine the personality of a person and their emotional functioning. They can be used to identify a mental illness' severity, like depression or anxiety. Psychological testing is typically done by psychologists who have been trained. The patient must follow specific instructions to obtain accurate results.
Psychological assessments can differ in terms of the number and type psychological tests used, depending on an individual's symptoms. A general psychiatric assessment could be brief, like the Mini-Mental State Examination, or extended and thorough, like the Montreal Cognitive Assessment. Neuropsychological tests can be used to determine if there is a concussion or brain injury.
All kinds of psychiatric tests provide a look at the patient's psychological and emotional functioning. In the hospital, doctors, psychologists and psychiatrists sometimes conduct these tests to evaluate a patient's mood and emotional reactivity as well as cognitive abilities. website Private therapists can also conduct them in their offices to gather data for an appropriate treatment plan, and to determine if patients would benefit from medication or a different method of therapy.
Psychological evaluations include tests for intelligence and achievement that measure various types of cognitive functioning (often called IQ) and performance in comparison to a normed group. Other tests are designed to assess the ability to perform tasks, for example, a word association test or a memory test. Psychologists are the only professionals with extensive training as well as experience conducting and interpreting psychological tests.
The purpose of a psychiatric assessment is to pair the patient with a physician who can provide treatment and management. The doctor will explain the diagnosis to the patient and how it relates with their symptoms. The doctor will also talk about the prognosis, which is how a particular diagnosis can be likely to develop in time.