The Psychiatric Evaluation

2018 ◽  
pp. 359-376
Author(s):  
Carol S. North ◽  
Sean H. Yutzy
Keyword(s):  
Mental Illness ◽  
Decision Tree ◽  
Psychiatric Disorder ◽  
Mental Status ◽  
Psychiatric Evaluation ◽  
Basic Principles ◽  
Specific Advice ◽  
History Of ◽  
Mental Status Examination ◽  
And Behavior

The psychiatric evaluation is a review of the basic principles of approaching a patient with a suspected psychiatric disorder. Specific advice is advanced regarding the interview style, questioning (open-ended versus closed), focus of interview (history of illness), and demeanor (e.g., friendly, sympathetic, respectful). The details of mental status examination are then reviewed with examples provided of positive findings in each of five categories: appearance and behavior, affect and mood, form and content of thought, memory and intellectual functioning, and insight and judgment. These examples are designed to flesh out the student’s understanding of mental illness. A decision tree is provided to facilitate efficient clinical focus on the major issues. Recommendations are provided for effectively presenting a case in a formal setting.

The Psychiatric Interview and Mental Status Examination

2017 ◽  
Author(s):  
Donald W. Black
Keyword(s):  
Differential Diagnosis ◽  
Social History ◽  
Mental Status ◽  
Treatment Plan ◽  
Essential Elements ◽  
Comprehensive Treatment ◽  
Psychiatric Interview ◽  
Psychomotor Activity ◽  
History Of ◽  
Mental Status Examination

The interview and mental status examination are integral to the comprehensive patient assessment and typically follow a standard approach that most medical students and residents learn. The psychiatrist should adjust his or her interview style and information-gathering approach to suit the patient and the situation. For example, inpatients are typically more symptomatic than outpatients, may be in the hospital on an involuntary basis, and may be too ill to participate in even the briefest interview. Note taking is an essential task but should not interfere with patient rapport. The interview should be organized in a systematic fashion that, although covering all essential elements, is relatively stereotyped so that it allows the psychiatrist to commit the format to memory that, once learned, can be varied. The psychiatrist should start by documenting the patient’s identifying characteristics (age, gender, marital status) and then proceed to the chief complaint, history of the present illness, past medical history, family and social history, use of drugs and alcohol, medications, and previous treatments. A formal mental status includes assessment of the patient’s appearance, attitude, and behavior; orientation and sensorium; mood and affect; psychomotor activity; thought process, speech, and thought content; memory and cognition (including attention and abstraction); and judgment and insight. With the data collected, the psychiatrist will construct an accurate history of the symptoms that will serve as the basis for developing a differential diagnosis, followed by the development of a comprehensive treatment plan. This review contains 1 figure, 3 tables, and 12 references. Key words: assessment, differential diagnosis, interviewing, mental status examination, treatment plan

Mental Status Examination of an Exceptional Case of Longevity

1995 ◽  
Vol 166 (2) ◽  
pp. 229-235 ◽  
Author(s):  
Karen Ritchie
Keyword(s):  
Mental Status ◽  
Verbal Memory ◽  
Protective Factor ◽  
Depressive Symptomatology ◽  
Extreme Case ◽  
Exceptional Case ◽  
Intellectual Ability ◽  
Language Fluency ◽  
History Of ◽  
Mental Status Examination

BackgroundThe mental status examination of an extreme case of longevity, J. C., aged 118 years and 9 months, is documented in order to further knowledge regarding profiles of morbidity in the extremely elderly. J. C. is presently considered to have the longest authenticated life-span in the history of the human species.MethodNeuropsychological tests were improvised taking into account the subject's severe perceptual deficits. The examination was carried out over a six-month period. A CT scan was also conducted.ResultsThe subject's performance on tests of verbal memory and language fluency is comparable to that of persons with the same level of education in their eighties and nineties. Frontal lobe functions are relatively spared and there is no evidence of depressive symptomatology or other functional illness. Cognitive functioning was found to slightly improve over a six-month period.ConclusionsThe subject shows no evidence of progressive neurological disease. A high initial level of intellectual ability may have constituted a protective factor.

Detecting a History of Incest: A Predictive Syndrome

1985 ◽  
Vol 66 (9) ◽  
pp. 525-532 ◽  
Author(s):  
Gerald S. Ellenson
Keyword(s):  
Women Survivors ◽  
Mental Status ◽  
History Of ◽  
Mental Status Examination

The author describes thought content and perceptual symptoms shared by women survivors of childhood incest. The syndrome, if confirmed, may make it possible to detect such incest, through the expanded use of a mental status examination, in one unstructured interview.

Depression in Chronic Hepatitis C Treated with Interferon: Prevalence and Management

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
A. Scalori ◽  
L. Gandossini ◽  
G. Santamaria ◽  
V. Bellia ◽  
T. Bordoni ◽  
...  
Keyword(s):  
Side Effects ◽  
Psychiatric Disorder ◽  
Minnesota Multiphasic Personality Inventory ◽  
Antidepressant Drugs ◽  
Chronic Viral Hepatitis ◽  
Psychiatric Evaluation ◽  
Patients At Risk ◽  
History Of ◽  
Ifn Therapy ◽  
Psychiatric Side Effects

Neuropsychiatric disturbances, from depression to psychosis and attempted or successful suicides are reported during interferon (IFN) therapy for chronic viral hepatitis. IFN schedule and history of psychiatric illness are not enough to predict who will develop symptoms.Aims:To assess the prevalence of depression during IFN therapy; to test whether a computerized version of the Minnesota Multiphasic Personality Inventory (MMPI) is a sensitive and reliable test for the early identification of patients at risk of depression before IFN therapy is started; and whether and how the depression can be cured. Patients. 185 patients treated with IFN.Methods:Before therapy, all patients underwent an MMPI and a clinical examination for identification of depressive symptoms.Results:Thirty-one patients developed a psychiatric disorder, 11 of them requiring treatment. Among the 18 patients with MMPI positive tests, 16 developed a psychiatric disorder (sensitivity of 0.58). Among the 154 who did not develop psychiatric side effects, 152 had a negative MMPI (specificity: 0.99). Severe psychiatric disorders (8 patients) were successfully treated with antidepressant drugs.Conclusions:Psychiatric side effects are easy to see during IFN therapy. An accurate psychiatric evaluation should be considered on all patients before treatment. However, as this specific examination cannot always be performed because of the lack of psychiatrists in liver units, it is necessary to identify tests, that are easy to carry out, reproducible, self-administered and inexpensive in order to screen all patients. If depression develops, it should be treated aggressively, and selective serotonin re-uptake inhibitors are the anti-depressant of choice.

The Mental Status Examination for Dementia: A Review of Practice in a Psychiatric Hospital*

1983 ◽  
Vol 28 (4) ◽  
pp. 287-290 ◽  
Author(s):  
B.A. Martin ◽  
A.M. Peter ◽  
M.R. Eastwood
Keyword(s):  
Cognitive Function ◽  
Mental Status ◽  
Discharge Diagnosis ◽  
Hospital Discharge Diagnosis ◽  
Organic Mental Disorders ◽  
Diagnosis Of Dementia ◽  
Recent Developments ◽  
History Of ◽  
Mental Status Examination

The mental status examinations of 63 patients with a hospital discharge diagnosis of dementia were reviewed. The examination and documentation of most areas of cognitive function were found to be incomplete in the majority of cases. The need for a complete examination of cognitive function is discussed in relation to the natural history of dementia and in the context of recent developments in the classification of organic mental disorders.

scholarly journals AN AYURVEDA CONCEPTUAL STUDY ON EIGHT DOMAINS IN THE ASSESSMENT OF MIND

2021 ◽  
Vol 9 (12) ◽  
pp. 3049-3054
Author(s):  
Dhaneshwari H. A ◽  
Suhas Kumar Shetty
Keyword(s):  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Mental Status ◽  
History Taking ◽  
Psychosomatic Disorders ◽  
Examination Techniques ◽  
Mental Status Examination ◽  
Thinking Process ◽  
Conceptual Study ◽  
Psychiatry Disorders

History taking, clinical examinations play a major role in confirming the diagnosis and predicting the prognosis of the illness. This is applicable in psychiatric as well as psychosomatic disorders. Sometimes organic diseases may simulate the presentation of psychiatric disorders and vice versa. Many types of examination techniques are ex- plained in Ayurveda which help directly or indirectly to elicit and diagnose psychiatry disorders. Astavibhrama, impairment in eight domains of mental faculties - thinking process (Mano vibhrama), intellect (Buddhi vibhrama), consciousness and orientation (Sanjnajnana vibhrama), memory (smriti vibhrama), desire or interest (Bhakti vibhrama), temperaments (sheela vibhrama), behaviour (chesta vibhrama), conduct (achara vibhrama); a concept adopted for the diagnosis of unmada (insanity). These eight domains can be generalised for eliciting the mental status of an individual. Keywords: Astavibhrama, Mental status examination, Psychiatric disorder

scholarly journals Effects after the lockdown on emergency room admissions for psychiatric evaluation: An observational study from the province of Forlì-Cesena, Italy

2021 ◽  
Vol 17 (3) ◽  
Author(s):  
Massimiliano Beghi ◽  
Riccardo Brandolini ◽  
Laura Biondi ◽  
Claudia Corsini ◽  
Carlo Fraticelli ◽  
...  
Keyword(s):  
Observational Study ◽  
Psychiatric Disorder ◽  
Emergency Room ◽  
Psychiatric Disorders ◽  
Psychiatric Diagnosis ◽  
Psychiatric Evaluation ◽  
Longitudinal Observational Study ◽  
Emilia Romagna Region ◽  
History Of ◽  
The Difference

The aim was to study the number of accesses to the Emergency Room (ER) requiring psychiatric evaluation in the four months following the lockdown period for the COVID-19 outbreak (May 4th, 2020-August 31th, 2020). The study is a retrospective longitudinal observational study of the ER admissions of the Hospitals of Cesena and Forlì (Emilia Romagna region) leading to psychiatric assessment. Sociodemographic variables, history for medical comorbidities or psychiatric disorders, reason for ER admission, psychiatric diagnosis at discharge and measures taken by the psychiatrist were collected. An increase of 9.4% of psychiatric assessments was observed. The difference was more pronounced in the first two months after lockdown, with a 21.7% increase of number of ER accesses, while after two months numbers were the same as those of the year before. Admission with anxiety symptoms and history of psychiatric disorder decreased significantly. Moreover, there is an age trend with an increasing age of admission.

Female Sex Offenders

1987 ◽  
Vol 150 (5) ◽  
pp. 615-620 ◽  
Author(s):  
Art A. O'Connor
Keyword(s):  
Mental Illness ◽  
Social Skills ◽  
Sex Offenders ◽  
Psychiatric Disorder ◽  
Previous History ◽  
Female Sex Offenders ◽  
Mental Handicap ◽  
High Incidence ◽  
Sex Offences ◽  
History Of

Information on 19 women convicted of indecency and 62 women convicted of other sex offences was examined. Those convicted of indecency offences often had poor social skills and had a high incidence of mental illness, mental handicap and alcoholism. Two were convicted of indecent exposure, a rare offence in women. In 39 (63%) of the sex offences with individual victims, the victims were children and in 9 cases the offender was the mother or step-mother. In 25 cases the women were convicted of aiding and abetting a male offender. Of those convicted of indecent assault on persons under 16 and of gross indecency with children, 48% had a previous history of psychiatric disorder.

The Psychiatric Interview and Mental Status Examination

2017 ◽  
Author(s):  
Donald W. Black
Keyword(s):  
Differential Diagnosis ◽  
Social History ◽  
Mental Status ◽  
Treatment Plan ◽  
Essential Elements ◽  
Comprehensive Treatment ◽  
Psychiatric Interview ◽  
Psychomotor Activity ◽  
History Of ◽  
Mental Status Examination

The interview and mental status examination are integral to the comprehensive patient assessment and typically follow a standard approach that most medical students and residents learn. The psychiatrist should adjust his or her interview style and information-gathering approach to suit the patient and the situation. For example, inpatients are typically more symptomatic than outpatients, may be in the hospital on an involuntary basis, and may be too ill to participate in even the briefest interview. Note taking is an essential task but should not interfere with patient rapport. The interview should be organized in a systematic fashion that, although covering all essential elements, is relatively stereotyped so that it allows the psychiatrist to commit the format to memory that, once learned, can be varied. The psychiatrist should start by documenting the patient’s identifying characteristics (age, gender, marital status) and then proceed to the chief complaint, history of the present illness, past medical history, family and social history, use of drugs and alcohol, medications, and previous treatments. A formal mental status includes assessment of the patient’s appearance, attitude, and behavior; orientation and sensorium; mood and affect; psychomotor activity; thought process, speech, and thought content; memory and cognition (including attention and abstraction); and judgment and insight. With the data collected, the psychiatrist will construct an accurate history of the symptoms that will serve as the basis for developing a differential diagnosis, followed by the development of a comprehensive treatment plan. This review contains 1 figure, 3 tables, and 12 references. Key words: assessment, differential diagnosis, interviewing, mental status examination, treatment plan

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