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A Full Psychiatric Assessment A psychiatric evaluation is the first step to getting proper mental care. The psychiatrist will ask you lots of questions regarding your work and personal life, the causes of stress, major trauma you've endured, and whether you have experienced any alcohol or drug problems. Background and History A full psychiatric examination or psycheval is a multidisciplinary process that is carried out in hospitals. It involves psychiatric nursing and occupational therapy, psychologists, and social workers. The psychiatrist is the one who compiles a detailed medical record and conducts a mental assessment. The information can be gathered through direct observation of the person being assessed themselves and carers, as well as through specific psychological tests. The doctor will ask about the patient's health issues and what the patient has done in the last few months, weeks, or years. They will also inquire about your family and health. This information can aid the doctor in determining the cause of symptoms and if they are the result another condition. In this stage, a psychiatrist will ask about your medical background to determine if there's a family history of anxiety, depression, or other mental disorders. They will also inquire whether there are any physical issues, such as heart disease or diabetes and what medications the person is taking or was prescribed. In addition, the psychiatrist will take note of present symptoms and how long they've been experiencing them for. They will also inquire with the patient about their life like their work and home environment. www.iampsychiatry.uk will also discuss the individual's previous treatment as well as the degree of adherence to it. Often, family members and carers provide information that the patient hasn't told them but this is a matter of confidentiality and doesn't violate their rights to privacy. Depending on the severity of symptoms, a range of additional tests and examinations might 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 tests can test spatial abilities, concentration memory, memory, as well as communication skills. It is important that all psychiatric assessments are carried out by qualified and experienced professionals. This will ensure that the diagnosis and treatment plan are correct. Mental Status Examination The mental state examination (MSE) can be a harrowing experience for the physician and patient. It is an “snapshot” of the patient at a specific moment in time, and is helpful in describing the patient's actions and thoughts at that moment. The MSE is also useful in describing how a patient's state of mind changes over time. For example, from depression to manic episodes. The MSE begins when the physician makes the first observations about the patient. It is usually done during the taking of the history. The way a patient interacts and behaves with the examiner can reveal an awful lot about the root cause of mental disorder. This can be the case with the sloppy appearance of a person who is depressed or the flamboyant style of manic patients. It could also be a sign of an absence of motivation or effort, like in a depressed person or an anxious person taking antipsychotic medication. When a psychiatric examination is undertaken it is best to do it when the patient is at ease and cooperative. Both the patient and examiner might feel uncomfortable during the interview. It is important to present a positive impression. The MSE is a brief portion of the overall intake evaluation, and the results should be carefully considered together with the results from other sources, such as imaging studies or lab tests. Similar to the physical exam as well, the MSE is not as well suited to a structured approach, and much of it is obtained through the physician's observations during the taking of a history. A thorough MSE will include descriptions of the appearance and behavior as also alertness and focus as well as speech and motor activity such as mood and affect, perception and thought and attitude as well as awareness. It should also include a thorough evaluation of higher cognitive abilities such as parietal lobe functions (pictorial construction, right-left discrimination, localization of objects in space) and frontal lobe executive or diffuse cerebral cortical functions (judgment, abstract reasoning memory). It is essential that the MSE be considered as part of a complete intake assessment and that doctors interpret the results with sensitivity and care. A thorough MSE can reveal a broad range of abnormalities, including some that are specific to psychiatric disorders, however, it should be considered as a singular data point in the patient's overall history and is of little clinical significance on its own. Reviewing the Content of Thoughts The thought content section is the biggest of the MSE sections and should contain information on delusional thinking (thoughts that aren't true) like jealous, persecutory, or grandiose thoughts and hallucinations (hearing or seeing things that others do not); preoccupations (such as obsessions, worries or fears) and suicidal thoughts. These questions should be clearly asked. The severity and the extent of the pathological thinking should be described. Also whether or not they are in sync with the mood (e.g. a patient who is depressed hearing voices that are angry or encouraging them to kill themselves versus hallucinations that are peaceful and calm). Thought process is the logic, relevance, coherence and flow of the client's thinking as they respond to the examiner's questions during the MSE interview. Doctors also look for signs that the thought process is disorganized or goal-directed and whether it moves rapidly from one topic to another without any clear connection between them. Mental health conditions like bipolar disorder, schizophrenia, and mania may be characterized by disorganized, tangential and circumstantial thinking processes. Psychologists and neuropsychologists also assess the client's attentional focus and capacity to hold information in short-term memory. This can be assessed through self-reports, examiner observations or tests that are brief like counting backwards starting at 100 and then multiplying it by sevens. They also assess the client's strategies to cope and cognitive performance in everyday life, which is measured through direct questioning and behavioral observations. During the MSE psychologists observe the client's body language and facial expressions to determine if they seem aggressive or withdrawn. They also observe the client's restlessness and fidgeting to determine if they are fearful or anxious. Psychologists typically use the MSE along with other tests and assessments to establish a diagnosis and formulate a treatment plan. Psychologists are trained to determine if a client's behavior is due to a mental disorder or caused by a different cause such as substance abuse, an accident or a medication side effect. This information is crucial in determining the appropriate treatment and follow-up care. Evaluation of Mood, Anxiety and Stress It's normal for people to experience difficult times. But when these difficulties begin to affect relationships, everyday tasks and even sleep, it might be time to make an appointment for a psychiatric evaluation. The mental health test is also known as “psych evaluation” and is typically conducted by a doctor or psychiatrist. The process can be a little intimidating and usually there's a lot of information that you'll have to share. It's important to remember that your psychiatrist wants to gather all the information so they can make a correct diagnosis and recommend the right treatment for you. A psychiatric assessment will include a review of your past medical history and an examination of your body. This is to confirm that there are no physical issues that could be causing your symptoms like a thyroid problem or a neurologic disorder. Your psychiatrist will also ask about any past psychiatric and medical conditions and if you are currently taking any medication. If a patient is not able to give a history because of their mental condition, it is essential that their family members and caregivers can answer the questions. This is not a violation of confidentiality and allows the physician to get more complete information than would be possible in a face-to-face interview. In the psychiatric consultation the doctor will evaluate the emotional state of the patient by observing their body speech and tone of voice. They will also evaluate their thoughts to determine whether they are goal-oriented and connected. For instance, the doctor will assess how well the patient can focus during the interview and if they can easily switch between thoughts. This is an important aspect to the assessment because a manic or psychotic patient might not be able think clearly and swiftly shift their focus. For many, a psychiatric evaluation is their first step towards getting the right treatment they require. It is essential that anyone who believes they suffer from symptoms of mental illness get an evaluation. Don't let your fear or anxiety stop you from seeking help as it could have life-threatening consequences for you and the people surrounding you.