General Psychiatric Assessment
The challenges of carrying out mental health assessments in general medical settings are numerous. This includes privacy issues, ward rounds and assessments by other specialties, secure time for meals and visits from family members.
In this regard, it can be difficult to quantify outcomes, particularly when it comes to disease-specific outcomes.
Medical Histories
The first step in the general psychiatric examination is to establish the medical history of the patient. This will include information about the patient's current condition as well as any medications they are taking and any major past medical problems that could affect their current health and well-being. This information will help the physician determine what psychological tests would be appropriate and the number of appointments they will require before determining a diagnosis.
This step is often difficult to complete on medical wards due the limited space available and interruptions due to visits to the ward, assessments by other specialties and allied health specialists, protected mealtimes and planned visitors. It is important to arrange an appointment time that is not in conflict with the other activities listed above and find a quiet space for the examination to be conducted. The referrer's specific concerns will help determine what type of psychotherapy evaluation is needed.
When performing psychiatric assessments on medical wards of general hospitals, it is important to remember that the physical health issues that patients present with may affect or even obscure their psychiatric symptoms and behaviour. This is a frequent issue that is referred to as diagnostic shadowing and is extremely difficult to avoid. For example, if the patient was admitted to a delirium hospital and they have a prior diagnosis of dementia on their medical records then it is tempting to "shadow" the delirium as if it is due to their mental illness, rather than carry out a full screening for delirium to rule out treatable causes like stroke.
It is essential that the psychiatrist assessing the patient tries to establish the relationship between the patient's physical and psychological problems and to elicit any concerns or complaints that the patient has about their treatment, care or way their health condition is being managed. Reference Osborn and Warner (1998) suggests an approach to achieve this. However, it can be difficult to implement in real life.
Family History
The psychiatrist will inquire about your family history to see whether there are any mental health problems within your family. They will also want to know about any experiences of abuse or trauma and your current social situation (including work, relationships and whether you have support at home). You could be asked about your religion, your dreams and ambitions. The psychiatrist will then formulate an assessment and formulate an appropriate treatment plan to suit your needs.
The psychiatrist should also look at physical symptoms. They will examine the patient's blood pressure and listen to the lungs and heart and search for any other medical issues that could be causing or aggravating the psychiatric symptoms.
It is helpful for psychiatrists to receive a complete physical from the patient's doctor, but this may not always be possible, particularly with those who are sick or inpatients in psychiatric units. Those on these wards may only have very infrequent face-to-face contact with psychiatrists or none at all. In such instances, it is essential that psychiatrists' nurses or care coordinators play a prominent part in ensuring these patients' physical health issues are met.
Psychiatrists must also be able to comprehend why a person is being referred to them, and what they are hoping to achieve through their psychiatric evaluation. They must be able to interpret medical letters and examine reports of tests from the GP or another health professional, and they must be able to communicate effectively with the person's medical team about what investigations have been conducted to ensure that any treatment or medication can be coordinated.
The medical history is an important element of any psychiatric examination. It should contain information about the patient's psychiatric diagnosis, past treatment and drinking and drug use. If it is possible, it is important to collect an entire family history to assess the likelihood of developing certain disorders, such as bipolar disorder. Screens to collect life-long psychopathological information from informants and first-degree relatives can be helpful but there is the benefit of obtaining a complete family psychiatric history as well.
Signs and symptoms
During the psychiatric assessment the doctor will ask you about your symptoms and how they've affected your life. Your doctor will also inquire about your family history and any other issues that could be relevant. It can feel intrusive at times, but you need to answer honestly and completely to ensure that you receive a correct diagnosis.
It is essential to undergo a psychiatric assessment when you are suffering from mental health issues, like anxiety or depression. This will tell you if you need treatment. It is normal to experience periods of depression and stress however should they last for more than one or two days or interfere with your daily life, then you may require treatment.
In addition to discussing your symptoms, your psychiatrist will also ask about any other issues that may be impacting your health, such as problems at work or with your family, or addiction issues. They will also ask about your physical health, sleeping habits and if you have tried other approaches to manage your symptoms.
Your psychiatrist could also ask you about your previous experiences with mental illness. They could also employ standardized assessment tools or psychological tests to get a better psychiatrist assessment understanding of your situation. These tests may include questionnaires, personality assessments or cognitive tests that measure your level of distress.
If your psychiatric assessment shows that you have psychotic symptoms, such as hallucinations and delusions that are a significant departure from what is thought to be real, then the psychiatrist might have to perform an in-depth exam and admit you to the hospital to be observed. You will be required to undergo a second evaluation by a psychiatrist before being allowed to go home.
Greater Lowell Psychiatric Associates will provide you with the support and care you need. The team of helpful and experienced professionals is committed to giving you the necessary information regarding the diagnosis you have received and possible treatment options. You can book a psychiatric examination via the internet or by calling today.
Psychological tests
A significant aspect of a psychological evaluation is the use of a variety of tests. Psychological tests are either written or verbal evaluations designed to measure unobserved constructs. They are often used to determine the personality of a person and their emotional functioning. They can be used to determine the severity of a certain mental illness, for example, anxiety or depression. Psychological testing is typically done by psychologists who have been trained. The patient must follow specific instructions to obtain accurate results.
Psychiatric assessments can vary in the number and type of psychological tests they utilize dependent on the person's condition and symptoms. A general psychiatric assessment may be short, such as the Mini-Mental State Examination, or extended and thorough, like a Montreal Cognitive Assessment. Neuropsychological testing can be used to determine if a patient has a concussion or brain injury.
All types of psychiatric examinations provide a look at the patient's emotional and psychological functioning. They are conducted by doctors, psychologists, and sometimes psychiatrists in the hospital setting to determine a person's current mood, emotional reactivity, and cognitive abilities. Private therapists are also able to conduct these tests in their offices to gather data to develop a treatment plan, and to determine whether the patient could benefit from medication or a different method of therapy.
Intelligence & Achievement Tests are a type of psychological assessments. These tests assess cognitive performance (often called IQ) in contrast to a normative group. Other tests are designed to test the ability to complete an activity, such as memory tests or the test of word association. Psychologists are the only professionals with extensive training and expertise to conduct and interpret psychological tests.
A psychiatric exam is designed to match the patient with a doctor who can offer treatment and management. After the exam is completed the doctor will inform the patient about the diagnosis and how it is related to their present symptoms. The doctor will also inform the patient about the prognosis. This is how a diagnosis is likely to develop in time.