Mental health articles

OF mental health care and mentally ill

How to do psychiatric assessment

There is a myth that psychiatric assessment differs from that in other medical specialties: it does not, it follows the familiar sequence of history, examination (both mental state and physical) and investigation, leading to differential diagnosis. Another myth holds that management cannot proceed without obtaining an extensive history that delves into all aspects of a patient’s life. Diagnosis can take only a few minutes, but time must be spent fleshing out the initial impressions, assessing immediate risks and collecting information about personal and social circumstances that modify symptoms or affect management and long-term prognosis. Accuracy is achieved by close attention to the pattern of evolution of presenting symptoms and examination of a patient’s mental state. A complete psychiatric assessment requires a detailed  personal history, which, if the doctor is not familiar with the patient, may be built up over a series of interviews. The important point is that such detail comes into play only once the basic problem has been ascertained clearly.

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