The psychiatric interview gathers information to formulate a diagnosis and then a treatment plan. The initial interview is lengthy, taking between45-60 minutes to complete. There are 13 parts to the psychiatric interview that starts with the identifying data and ends with the treatment planning (Carlat, 2017) Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales Essay Examples.
Of the 13 parts, the three that this author would consider the most important are: past psychiatric history, mental status exam, and treatment planning. The past psychiatric history is vital to the interview as it gives a glimpse into what types of treatment, if any, the patient has had before. Knowing if a patient has been hospitalized in the past voluntarily or involuntarily can shed enormous light on the patient’s present symptoms. If the patient does not have a psychiatric history, the provider can focus on any medical changes that may have the patient present with these symptoms (Sadock et al., 2017). The Mental Status Exam (MSE) can provide valuable information regarding the patient’s current mental state. The information obtained from the 12-part MSE provides the criteria for a diagnosis to be made by obtaining data that varies from the appearance and behavior of the patient to their thought content and processes to their insight and judgment (Carlat,
2017). The third piece of the psychiatric interview that this author deems to be most important is the treatment plan. Gathering data and formulating an accurate diagnosis is only as important as having a plan made with the patient, when possible, to help them best manage their symptoms. A good treatment plan can assist a patient in functioning in life at their full capacity. Each treatment plan is specialized for each patient and considers any comorbidities, barriers, and support needed
for the plan to be functional (Sadock et al., 2017).
If a patient has symptoms of major depressive disorder (MDD), the gold standard tool used to determine the severity of the depression is the Hamilton Depression Rating Scale (HAM-D). The questions on this scale (ranging between 17 and 27 depending on the focus, such as focusing on Seasonal Affect Disorder) review items such as insomnia or hypersomnia, weight gain or weight loss, work and activity, suicidality, and anxiety. This scale rates the severity of depression for appropriate treatment, and also serves as a tool to determine if the prescribed treatment is effective. A nurse practitioner would utilize this tool for any patient that presents with depression symptoms, for diagnosis, and for follow-up (Rohan et al., 2016).
References
Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer.
Rohan, K. J., Rough, J. N., Evans, M., Ho, S. Y., Meyerhoff, J., Roberts, L. M., & Vacek, P. M. (2016). A protocol for the Hamilton Rating Scale for Depression:
Item scoring rules, Rater training, and outcome accuracy with data on its application in a clinical trial. Journal of affective disorders, 200.
https://doi.org/10.1016/j.jad.2016.01.051
Sadock, B., Sadock, V. A., & Ruiz, P. (2017). Kaplan and Sadock’s concise textbook of clinical psychiatry. Wolters Kluwer.
Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales Essay Examples sample 3
Assessment and Diagnosis of Psychiatric Patient
Three Important Components of Psychiatric Interview
An interview, or obtaining a comprehensive history, is the first step of care for a patient seeking healthcare services. Psychiatry patients are exposed to psychiatry interview that facilitates collection of crucial details such as biographical data, family history, chief complains or symptoms, past psychiatric history among others. The biographical data is important for patient identification; a crucial aspect of care, especially in psychiatry facility. The biographical data collected entails, the name, sex, education level, religion, marital status, nationality and place of residence (Williamson & Thoms, 2014). This information is crucial for identifying the patient, for statistical evidence, and in future planning. Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales Essay Examples
The second component is the chief complain and symptoms. This component allows the patient to freely and categorically explain what prompted them to seek professional care. The complaints are noted as per their onset date, affected area or part of the body, severity and what factors reduce or increase the symptoms (Williamson & Thoms, 2014). In light of this component, the healthcare practitioner is able to understand the patient better by creating a rapport, identifies symptoms and evaluates behavior of patient.
The third component of psychiatry interview is the patient’s past psychiatric history. Under this phase, the patient is asked if they have ever experienced the symptoms before, and if they have been hospitalized for them (Williamson & Thoms, 2014). Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales Essay Examples In a case where the patient has been admitted with a psychiatry condition, the drugs that they were prescribed are noted. Any known allergies to food and drug components are also recorded. This component helps psychiatry practitioners to identify if the condition is re-occurring or if it is a new onset.
The Saint Louis University Mental Status Exam Rating Scale
In an effort to assess the extent and severity of any mental disorder, rating scales are used. The Saint Louis University (SLU) Mental Status Exam was employed as an assessment tool to establish the extend of not only cognitive impairment but also dementia(Shwartz et al., 2017). The SLU Mental Status Exam comprises of eleven questions that have varied properties. For instance, questions 1 to 3 assess the patients’ ability to recall past incidences, orientation and attention to details. Questions 4 and 7 assess the ability to recall delayed incidences despite being interfered with. Question 5 evaluates the ability of the cognitive function to accomplish numerical calculations. Questions 6, 8 and 9 assesses the memory, registration and visual spatiality of the patient respectively(Lane & Noronha, 2011). Lastly, questions 10 and 11 assess the executive functioning of the patients’ mental state.
When it is Appropriate to Use SLU Mental Exam
The SLU Mental Exam is usually applied in assessment of patients who are suspected to have dementia or cognitive functioning related mental illnesses. Such a rating scale is applicable only when the psychiatric practitioner suspects that the patient has a cognitive functioning disease such as dementia (Lagervall et al., 2019). The SLU Mental Exam rating scale helps practitioners to assess the severity or confirm presence of the cognitive functioning disorders such as dementia among others(Cruz-Oliver et al., 2012).
References
Cruz-Oliver, D. M., Malmstrom, T. K., Allen, C. M., Tumosa, N., & Morley, J. E. (2012). The veterans affairs Saint Louis University mental status exam (slums exam) and the mini-mental status exam as predictors of mortality and institutionalization. The journal of nutrition, health & aging, 16(7), 636-641. https://doi.org/10.1007/s12603-012-0098-9
Lagervall, J. A., Ingram, R. E., & Feliciano, L. (2019). Saint Louis University mental status examination and older adults. Encyclopedia of Gerontology and Population Aging, 1-5. https://doi.org/10.1007/978-3-319-69892-2_623-1
Lane, G., & Noronha, D. O. (2011). Saint Louis University mental status exam in practice: A quality improvement project. PsycEXTRA Dataset. https://doi.org/10.1037/e696782011-001
Shwartz, S. K., Morris, R. D., & Penna, S. (2017). Psychometric properties of the saint Louis University mental status examination. Applied Neuropsychology: Adult, 26(2), 101-110. https://doi.org/10.1080/23279095.2017.1362407
Williamson, T., & Thoms, L. (2014). Psychiatry. The Practical Pocket Guide to History Taking and Clinical Examination, 145-154. https://doi.org/10.1201/b20744-15 Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales Essay Examples
