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A Full Psychiatric Assessment A psychiatric examination is the first step towards receiving the proper treatment for your mental health. The psychiatrist will ask you a number of questions about your job and personal life, the causes of stress, any major trauma you've had, as well as if you have had any issues with alcohol or drugs. Learn More Here and History A full psychiatric assessment, also known as psych eval, is usually a multi-disciplinary procedure in hospitals that involves psychiatric nurses, occupational therapists, psychologists and social workers. However, the psychiatrist takes the lead role in taking a detailed medical history and performing a mental state examination. The information can be obtained by direct observation of the person being examined and their caregivers as well as specific psychological tests. The doctor will ask about the patient's symptoms as well as what the patient has done in the past few months, weeks, and years. They will also ask questions about personal and family health. This information will allow the doctor to know what is causing the symptoms and if they're the result of another condition. In this stage the psychiatrist will inquire about your medical history to determine if you have an ancestral history of anxiety, depression, or other mental disorders. They will also need to know if the person has any physical problems, such as diabetes or heart disease, and what medications they are currently taking or were prescribed in the past. The psychiatrist will also be aware of any symptoms that are present and the duration they've been suffering. They will also ask the patient about their daily routine including their work and home life. They will also discuss the patient's previous treatment and extent of their adherence to it. In many cases family members and caregivers offer information that the patient has not told them however, it 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 may be required. These could include laboratory tests, blood pressure readings or electroencephalography (EEG), which measures brain activity. They might also use IQ tests, which test cognitive ability. They can test spatial abilities, concentration, memory and communication skills. All psychiatric examinations should be conducted by a professional who are experienced and qualified. This will ensure the diagnosis is correct and that the patient receives a treatment plan that best suits their needs. Mental Status Examination The mental state examination (MSE) can be a painful experience for both the physician as well as the patient. It is an “snapshot” of the patient in a specific moment in time, and is helpful in describing the patient's actions and thoughts at the time. The MSE can also be useful in demonstrating how a patient's state mind changes over time. For example, from depression to manic episodes. The MSE starts with the doctor's initial observations of the patient during the taking of a medical history. The how a patient interacts and behaves around the examiner can reveal something about the root of the mental disorder. This can be the case with the sloppy appearance of a depressed person or the an aggressive style of a manic patient. It could also signal a lack 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. It is a stressful and uncomfortable experience for both the patient and the examiner, and it is crucial to present a positive impression. The MSE should be only a small part of the overall intake evaluation. Its results should also be carefully compared with the results from other sources like imaging studies or laboratory tests. The MSE is not as structured as physical examinations and most of the information is gathered by the physician during the history-taking process. Nevertheless, a detailed MSE should include descriptions of general appearance and behavior, alertness and attention, motor and speech activity, mood and affect, thinking and perception, attitude and understanding. It should also include a detailed assessment of higher cognitive functions such as parietal lobe functions (pictorial construction and right-left discrimination, as well as the localization of objects in space) and frontal lobe executive or diffuse cortical functions (judgment abstract reasoning memory). It is crucial that the MSE is considered in the context of the full intake assessment and that doctors interpret the results with sensitivity and care. A thorough MSE will reveal a wide spectrum of abnormalities, which includes those that are specific to psychiatric disorders, however, it should be considered as a single point of data within the overall patient's history and is of little clinical significance on its own. Assessing the Content of Thoughts The thought content section is the most extensive of the MSE sections and should include information about delusional thinking (thoughts that aren't true) for example, jealous, persecutory or grandiose ideas and hallucinations (hearing or seeing things others do not) Preoccupations (such as worries, obsessions or phobias) and suicidal ideas. These questions should be directly asked. The severity and the extent of the psychopathic thinking needs to 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). The thought process is the logic, relevance and coherence of the client's responses to MSE interviewer's questions. Physicians will also note whether the thought process is disorganized or goal-directed, and if it jumps from one topic to the next without any clear connection. Disorganized, tangential, and circumstantial associations are thought processes that may be indicators of mental health issues like schizophrenia, mania and bipolar disorder. Psychologists and neuropsychologists evaluate the client's ability to focus attention and briefly hold information in their memory. This can be assessed through observer observations, self-report or tests like counting backwards from 100 by 7s. They also evaluate the client's coping strategies and cognitive functioning that is measured through direct questions and observations. During the MSE psychology, psychologists watch the client's facial expressions as well as body language to determine whether they appear to be withdrawn or aggressive. They also look at the client's restlessness or fidgeting to determine if they're scared or anxious. Psychologists typically use the MSE together with other tests and assessments to make diagnose and create the treatment plan. Psychologists are also trained to determine if the client's behavior is similar to a particular mental illness or is instead due to a different cause such as alcohol abuse, injury or an adverse reaction to medication. This information is crucial in determining the most appropriate treatment and follow-up. 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 or even sleep, it might be time to make an appointment for a psychiatric evaluation. The mental health test is also known as a “psych evaluation” and is usually conducted by a psychiatrist or a doctor. It can be a bit intimidating, and you will need to provide a wealth of personal information. It's important to remember that your therapist will want to collect all the relevant information so that they can come up with a valid diagnosis and recommend the best treatment for you. A psychiatric examination will consist of an examination of your prior medical history and physical examination. This is to ensure that your symptoms are not caused by a physical problem such as a thyroid disorder or a neurological disorder. Your psychiatrist will also ask about any psychiatric or medical issues, as well as whether you are currently taking any medication. When patients are unable to provide a background due to their mental condition, it's crucial that their caregivers and family members are able to answer the doctor's questions. This is not a breach of confidentiality and allows the doctor to gather more details than he would in a face-to-face interview. During the psychiatric examination the doctor will examine the patient's emotional state by observing their voice and body language. They will also look at their thoughts to determine whether they are focused and related. The doctor will examine, for example, how the patient is able to focus and switch between thoughts during the interview. This is an essential aspect to the assessment because a manic or psychotic patient might not be able to think clearly and quickly shift their focus. A psychiatric assessment is often the first step to get the care you need. Despite the stigma associated with mental illness, it's essential that anyone who suspects suffering from the symptoms of a mental disorder seek an evaluation. Don't let fear or anxiety keep you from seeking help because it could have life-threatening consequences for yourself and others surrounding you.