Term
| What are the major sections of a written psychiatric evaluation? |
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Definition
2 Major elements are History and Mental Status
1) Subjective
- CC
- HPI
- Past psychiatric history
- PMH
- FH/SH/ROS
2) Objective
- PE
- Mental Status
- Labs/Radiology
3) Assessment
- Discussion of case
- Differential
4) Plan
- Further assessment
- Testing
- Treatments |
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Term
| What are the major elements of a strong psychiatric history? |
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Definition
- May be unreliable, so use DIRECT quotations
- Take symptom cluster approach with pertinent +/-
1) CC
2) HPI
- chronology
- precipitants
- onset/course
- better/worse
- effects of illness
- pertinent +/-
3) Past psychiatric history
- previous symptoms
- past treatments
- dangerousness
4) PMH
- current meds
- past meds/surg
- medications
- allergies
5) FH
- psychiatric and medical
6) SH
- substance abuse is critical*** |
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Term
| What are the 7 important facets of the mental status examination (MSE)? |
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Definition
1) Appearance/Behavior
2) Mood/Affect
3) Speech
4) Thought (process/content) (lethality?)
5) Perception
6) Cognition/Sensorium
7) Insight/Judgment |
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Term
| What are the critical aspects of an Assessment of MSE? |
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Definition
Objective observation of patients current psychiatric status that should be recorded for EVERY patient encounter.
- use subheadings to aid organization
**Variable recording of data can be an issue when there is "no right place." |
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Term
| What is the difference between an MSE and MMSE? |
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Definition
MSE is broad overview of person's overall mood, thought and behavior
2) MMSE is on small component of full MSE |
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Term
| What are the crucial differences between a Psychiatric evaluation of Children and that of Adults? |
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Definition
1) Information to focus on
- prior consent
- collateral information from school and family
- importance of age-appropriate play, vocab, cognition
- sensitivity of child to transitions
- general desire of young children to please
- comparisons between child and contemporaries
2) MSE
- Ease of separation
- Manner of relating
- Gross and fine motor, handedness
- Right-left differentiation
- Attention span
- Sensory difficulties
- Reading/writing/language
- Speech, language
- Intelligence
- Special feelings/fantasies |
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Term
Which of the following elements is NOT part of the standard psychiatric assessment?
a. Roschach test
b. Past psychiatric history
c. Assessment of psychomotor activity
d. FMH |
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Definition
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Term
The MSE is analogous to the PE in that it:
a. Compares previous findings with present ones
b. Interprets findings
c. Is an organized way of observing and reporting findings from time of contact with patient
d. Records superfluous findings. |
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Definition
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Term
Most of the MSE can be described by a trained observer after:
a. Any patient interview
b. Consultation with a neuropsychologist
c. Formal cognitive testing
d. Neuroimaging
e. Only a very lengthy patient interview |
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Definition
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Term
A patient is paranoid. Where in the MSE would you include that information?
a. Behavior
b. Judgment
c. Perception
d. Speech
e. Thought |
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Definition
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Term
How is collateral information used in psychiatric assessments?
a. Sparingly- diagnosis derives from the patient's subjective account combined with your objective MSE
b. Collateral information is important in just about every psychiatric assessment.
c. Primarily when evaluating children and adolescents
d. Serves as justification for involving families and other interested parties in treatment planning. |
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Definition
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Term
All of the following statements about the psychiatric assessment of preschool-age children are true, EXCEPT:
a. Collateral information should be obtained from parents, but the assessment should be conducted independently and without parents present.
b. Examiners must be wary of the general desire, present at this development stage, for children to try to please adults.
c. Gross and fine motor skills should be assessed by the psychiatric examiner
d. The assessment should be conducted while the child is engaged in some age-appropraite activity, like coloring. |
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Definition
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Term
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Definition
| Subjective, Objective, Assessment and Plan |
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Term
| Explain the basic structure of an Assessment? |
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Definition
1) Formation- brief summary of the history and exam, framed in such a way that it leads to a DD
2) DD- Written in DSM-IV multiaxial format (I-V)
- I shows rule-outs
- II usually "defer"
- show your thinking! |
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Term
| What key elements should a "plan" convey? |
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Definition
1) Further work-up needed to clarify
2) Disposition (inpatient, outpatient, IOP, jail, home-based)
3) Commitment status (voluntary vs. involuntary)
4) Biological treatment
5) Psychological treatment
6) Social interventions
- Conclude with statement about prognosis and expectations (length-of-stay) |
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Term
Which statement best describes how diagnoses should be presented in the psychiatric assessment?
a. Axis I and II diagnoses should be listed by the psychiatrist; the primary care provider lists Axis II diagnoses, while the social worker lists IV and V.
b. Its almost never appropriate to defer diagnosis; that implies inadequate assessment.
c. Its best to state a clear final diagnosis rather than including multiple "rule outs"
d. The evaluator should generate as broad a differential diagnosis as possible, including rule-outs for secondary causes like sub-induced or general medical conditions. |
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Definition
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Term
All the following components should be included in a treatment plan, EXCEPT:
a. Disposition
b. Further work-up required
c. Laboratory test results
d. Psychosocial treatments. |
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Definition
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