A Full Psychiatric Assessment

A psychiatric evaluation is the first step to getting proper mental care. The psychiatrist will ask you a number of questions about your work and private life, sources of stress, any major traumatic experiences you have experienced, and if you have had any alcohol or drug problems.

Background and Histories

A full psychiatric assessment, or psych eval, is typically a multi-disciplinary exercise in hospital settings that involves psychologists, occupational therapists and social workers. The psychiatrist is the one who compiles the medical records in detail and conducts a mental assessment. The information could be gathered through direct observation of the person being examined themselves and carers, and also 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 inquire about your family and personal health. This information will help the doctor determine what is causing the symptoms and if they're the result another illness.

During this phase, a psychiatrist will ask about your medical background to determine if there's a family history of depression, anxiety, or other psychiatric disorders. They will also ask if there are any physical issues, such as heart disease or diabetes and what medications the person is taking or has been prescribed.

The psychiatrist will also keep track of any symptoms that are present and the duration they have been present. They will also inquire about the person's life which includes their work and their home. They will also discuss the person's previous treatment and extent of their adherence to it. Carers and families often share information the patient hasn't told them. This is done out of respect for confidentiality and does not violate their privacy rights.

Depending on the severity, additional tests and examinations may be needed. These could include laboratory tests, blood pressure readings or electroencephalography (EEG), which measures brain activity. They may also use IQ test, which measures cognitive ability. These can test spatial skills, concentration, memory and communication abilities.

All psychiatric tests must be conducted by professionals who are skilled and knowledgeable. This will ensure the diagnosis is accurate and that the patient receives a treatment program that best suits their needs.

Mental Status Examining

The mental status examination (MSE) can be a harrowing experience for the physician and patient alike. It's a "snapshot" of the patient in a specific moment, and is useful for describing the patient's behaviours and thoughts at that moment. The MSE can also be useful in describing how a patient's mental state changes over time, such as from depression to mania.

The MSE begins with the doctor's initial observations of the patient, usually during the history-taking. The way a patient interacts the examiner and with their surroundings can reveal vital information about the root of the disorder in the psyche. This includes the discolored appearance of a depressed person or the an aggressive style of manic patients. It can also indicate a lack of motivation or energy, like in a depressed person or an agitated person taking antipsychotic medication.

If a psychiatric test is undertaken it is best when the patient is at ease and cooperative. It can be a difficult and uncomfortable experience for the patient and the examiner, and it is important to make a good impression. The MSE should only serve as a small part of the overall intake assessment. Its results must be carefully compared with other results such as imaging studies or tests in the laboratory.

Similar to the physical exam, the MSE does not lend itself to a structured approach and the majority of it is gathered through the physician's observations during the taking of a history. However, a thorough MSE should include descriptions of the general appearance and behavior, alertness and attention in speech and motor activities mood and affect, thoughts and perception as well as attitude and understanding. It should also include a review of higher cognitive abilities like parietal-lobe function (pictorial representation as well as right-left discrimination and localization of objects within space).

It is crucial that the MSE is considered in the context of the complete intake assessment and that physicians interpret the results with sensitivity and care. A thorough MSE will reveal a wide variety of abnormalities, including those that are specific to psychiatric disorders, however, it should be considered as a singular data point in the overall history of the patient and has little clinical value by itself.

Assessment of Thought Content

The largest section of the MSE is the thought content. It should include here details on delusional thoughts (thoughts that are not real) - such a persecutory or grandiose idea; hallucinations, (hearing things or seeing things that other people cannot) Preoccupations (such as worries or obsessions) and suicidal thought. These questions should be clearly asked. The severity and the extent of the pathological thinking should be described. Also, whether or not they correspond to the mood (e.g. a patient who is depressed hearing voices that are angry or urging them to kill themselves versus hallucinations that are soothing and calm).

Thought process refers to the logic, relevance, coherence and flow of the client's thinking as they respond to the questions of the examiner during the MSE interview. Physicians will also determine if the thought process is unorganized or goal-oriented, and also if it jumps from one subject to the next without a clear connection. Disorganized, tangential and circumstantial associations are thought processes that could be indicators of mental health issues such as schizophrenia, mania and bipolar disorder.

Psychologists and neuropsychologists also assess the client's attentional focus and ability to hold information in short-term memory. This can be measured by examiner observations, self-reports or tests that are brief, such as counting backwards beginning at 100 and multiplying it by sevens. They also can assess the client’s coping mechanisms and cognitive functioning, which is assessed by direct questions and behavioral observations.

During the MSE psychological evaluation, psychologists look at the client's facial expressions as well as body language to assess whether they appear to be withdrawn or aggressive. They also look at the client's restlessness and fidgeting to determine if they are fearful or anxious. Psychologists utilize the MSE together with other tests and assessments to diagnose and formulate a treatment program. Psychologists are also trained to detect the signs that a client's behavior may be in line with a specific mental illness or is instead due to a different cause such as addiction to drugs, an injury or an adverse reaction to medication. This is essential in determining the best treatment option and follow-up.

Evaluation of Mood, Anxiety and Stress

It's normal to experience difficult times. However, when these issues start to affect relationships, daily tasks or even sleep, it could be time to make an appointment for a psychiatric evaluation. This test for mental health is also known as "psych eval" and is usually conducted by a psychiatrist or doctor. It can be daunting, and you'll need to provide a wealth of personal details. However, it's important to understand that your therapist is trying to get all the facts so they can provide a correct diagnosis and suggest the best treatment for you.

A psychiatric evaluation will consist of an examination and review of your medical history. This is to confirm that there are no physical issues that could be causing your symptoms such as a thyroid problem or neurologic disorder.

Additionally, your psychiatrist will ask you about any other psychiatric or medical issues you've experienced in the past and if you're taking any medication currently. In cases where the patient is unable to give a history because of their mental state it's important that their family members and caregivers are able to answer the questions. This is not a breach of confidentiality and it allows the doctor to obtain more information than would be possible during a face-toface interview.

In the psychiatric consultation the doctor will evaluate the patient's emotional state by observing their voice tone and body language. They'll also look at their thoughts to determine if they're related and goal-directed. For example the doctor will examine how the patient is able to focus during the interview and if they can easily switch between ideas. This is an important aspect of the evaluation, since patients who are manic or psychotic may not be able to think clearly or quickly change their focus.

A psychiatric assessment is often the first step in getting the care you require. Despite the stigma associated with mental illness, it's imperative that anyone who suspects they're suffering from the symptoms of a mental disorder seek out an evaluation. Don't let your anxiety or fear prevent you from seeking help. It could have dire consequences for you and those around.