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A Full Psychiatric Assessment A psychiatric examination is the first step in receiving proper mental health care. The psychiatrist will ask you a number of questions about your family and work environment, stress sources, traumatic experiences you've had and any drug or alcohol issues. Background and Histories A complete psychiatric evaluation, or psych eval is typically a multi-disciplinary exercise in hospitals that includes psychiatric nurses, psychologists, occupational therapists and social workers. The psychiatrist is the one who compiles the medical records in detail and conducts a mental assessment. This information can be gathered by direct observation of the person being evaluated and their carers and through specific psychological tests. The doctor will inquire with the person about their symptoms and what they've been up to in the last few weeks, months, and years. They will also ask about your family and health. This information will help the doctor to understand what is the cause of the symptoms, and whether they are due to a different issue. In this stage an psychiatric doctor will inquire about your medical background to determine if there is an ancestral history of anxiety, depression or other mental health disorders. They will also inquire whether there are any physical concerns such as heart disease or diabetes and what medications the person is taking or has been prescribed. Additionally the psychiatrist will make note of present symptoms and how long they've been suffering for. They will also inquire about the person's life which includes their work and their home. They will also discuss the patient's prior treatment and the extent of their adherence to it. Often family members and caregivers offer information that the patient has not disclosed but this is a matter of confidentiality and doesn't violate their rights to privacy. Based on the severity, other tests and/or observations may be required. These could include laboratory tests, blood pressure readings or electroencephalography (EEG), which measures brain activity. They may also use IQ test, which tests cognitive ability. These can test spatial skills as well as concentration, memory and communication abilities. All psychiatric tests should be performed by professionals who are experienced and qualified. This will ensure that the diagnosis is correct and that the person is offered a treatment plan that is best suited to their needs. Mental Status Examination The mental status examination (MSE) can be a harrowing experience for both the doctor as well as the patient. It is an “snapshot” that is an image of the patient at a certain moment. It can be used to record the patient's thoughts and behaviours at the time. The MSE can also prove useful in describing how a person's mental state changes over time, for example, from depression to mania. The MSE begins when the physician makes the first observations of the patient. It is usually taken during the recording of the history. The way a patient interacts and behaves in front of the examiner can reveal an awful lot about the root cause of mental disorder. This includes the discolored appearance of a depressed individual or the exuberant manner of manic patients. It could also signal an absence of motivation or effort, such as in a depressed individual or an anxious person taking antipsychotic medication. It is ideal to conduct a psychiatric exam when the patient is at ease and cooperative. It is a stressful and uncomfortable experience for the patient and the examiner and it is important to make a good impression. The MSE is a brief portion of the overall intake evaluation, and the results should be carefully considered in conjunction with findings from other sources like laboratory tests or imaging studies. As with the physical exam it is the MSE does not lend itself to a structured approach and much of it is obtained from the physician's unstructured observations during history-taking. A thorough MSE will include descriptions of the appearance and behavior as well as alertness and attention to speech and motor activities, mood and affect, perception and thinking and attitude, as well as understanding. It should also include a thorough evaluation of higher cognitive functions like parietal lobe function (pictorial construction and right-left discrimination, as well as spatialization of objects) and frontal lobe executive or diffuse cortical functions (judgment, abstract reasoning memory). It is vital that the MSE is incorporated into the context of the entire intake assessment and that physicians interpret the results with care and sensitivity. A thorough MSE may reveal a variety of abnormalities, some of which are specific to mental disorders. However, it should be viewed as one data point within the patient's history and is of no clinical significance. Assessing Thought Content The thought content section is the most extensive of the MSE sections and should include details about delusional thoughts (thoughts that are untrue) like jealous, persecutory, or grandiose ideas as well as hallucinations (hearing or seeing things that others do not) and preoccupations (such as obsessions, worries or fears) and suicidal thoughts. These questions should be explicitly asked. redirected here and extent of the pathological thoughts should be outlined, along with whether they are mood compatible or incongruent (e.g. someone who is depressed hears voices that are angry or encouraging them to kill themselves, versus hallucinations that are calm and soothing). Thought process is the logic, relevance, coherence and flow of the client's thinking as they respond to the questions of the examiner during the MSE interview. Doctors also look for signs that the thought process is disorganized or goal-directed and if it flits from one topic to another without a obvious connection between them. Mental health conditions like schizophrenia, bipolar disorder, and mania can be indicated by tangential, unorganized, and circumstantial thought processes. Psychologists and neuropsychologists evaluate the capacity of the client to pay on a single subject and then hold it in memory. This can be determined through observer observations, self-report, or short tests such as counting backwards from 100 by 7s. They also evaluate the client's strategies for coping and cognitive functioning in daily life, which is assessed through direct questioning and behavioral observation. During the MSE psychologists will be observing the client's facial expressions and body language to determine if they appear anxious or withdrawn. They also look at the client's fidgeting and restlessness in order to determine whether they are anxious or scared. Psychologists often employ the MSE together with other tests and assessments to determine a diagnosis and formulate a treatment plan. Psychologists are trained to determine the severity of a client's behavior due to a mental disorder or caused by a different cause such as substance abuse, an accident or a medication adverse effect. This information is crucial to determining the best treatment and follow-up. Evaluation of Mood, Anxiety, and Stress There are times when we all experience hardships and when those issues begin to affect relationships, daily activities and even one's ability to sleep, it could be the right time to schedule a psychiatric evaluation. Also called a psych evaluation and a mental health check, this exam is typically performed by a psychiatrist or doctor. The procedure can be a little intimidating and you'll usually have plenty of information you'll need to provide. It's crucial to realize that your therapist is trying to get all the information they need so that they can make an accurate diagnosis and recommend the best treatment for you. A psychiatric assessment will include a review of your past medical history as well as physical examination. This is to confirm that there aren't any physical problems that could be causing your symptoms such as a thyroid problem or neurologic disorder. Your doctor will also inquire about any past psychiatric and medical conditions and whether you are currently taking any medication. If a patient is not able to provide a medical background due to their mental health it is crucial that the caregivers and family members of the patient are able to respond to the questions of the doctor. This is not a violation of confidentiality and allows the physician to get more information than could be obtained in a face-to-face conversation. In the psychiatric consultation the doctor will evaluate the patient's emotional state by paying attention to their voice tone and body language. They will also look at their thoughts to see whether they are goal-oriented and related. For instance the doctor will assess how the patient is able to focus during the interview, and if they can easily switch between different ideas. This is an important aspect to the evaluation as the manic or psychotic patient may not be able to think clearly and quickly shift their attention. For many seeking a psychiatric assessment, it's their first step towards getting the appropriate treatment they require. It is crucial that anyone who believes that they are suffering from symptoms of mental illness get an evaluation. Don't let your anxiety or fear prevent you from seeking assistance. It could have a serious impact on the people around you as well as for yourself.