Psychiatric Evaluation Flashcards
In general terms what is a psychiatric evaluation?
Require information to make a DSM diagnosis
Be able to assess person risk for suicide or aggressive behaviors
Determination of inpatient or outpatient status and voluntary vs. involuntary care
What is an MSE (mental status exam)
Observations during interview supplemented by specific and direct questions
Nonetheless, a routine or template is required to ensure a complete exam.
Not the same as the Mini-Mental State Exam
A useful template for performing an MSE is called A.S.E.P.T.I.C. Each card will explain each letter. A –>
A: Appearance, Attitude, Accessibility, and Behavior
A.S.E.P.T.I.C. S–>
S: Stream of Mental Activity (as inferred from) speech
speech can be accelerated or slow or etc..
A.S.E.P.T.I.C. E–>
E: Emotional State including Mood (generalized more pervasive, tell me what your mood is like and what number would you give it for the last week) , Affect (based on facial expression, body language, tone or content of speech and attire), Neurovegatative symptoms (SIGECAPS (SEAS–> considered the neuroveg symptoms) and Suicidality (must ask this)
A.S.E.P.T.I.C. P–>
P: Hallucinations, Pseudohallucinations and illusions
depersonalization/derealization
A.S.E.P.T.I.C. T–>
T: Thought (and language): disorders of production, form and content of thought
(you are not producing thought then you have poverty of thought)
A.S.E.P.T.I.C. I–>
I: Insight and judgement
A.S.E.P.T.I.C. C–>
C: Cognition (Conscious), Orientation, Memory, Intelligence or concentration
What is a MMSE (mini mental state exam)
More rigid, structured exam needs an introduction takes 3-5 minutes allows longitudinal index good inter rater reliability original version by Folstein
What are the specific tests in an MMSE?
- Orientation (place, time)
- Registration, Recall
- Attention
- Language
- Visual-Spatial
What does the MMSE screen for?
Aphasia Ability to follow a written command Ability to write a sentence Apraxia Executive function testing
What does the MMSE quantify?
Orientation
Registration
Recall
Serial Calculations
What must you ask in the interview or else fail the OSCE?
Drugs, alcohol and suicide
In depression sometimes patients can experience what specific symptom?
Hearing voices
