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Nov 24, 2024

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Psychiatric Interview. A psychiatric assessment is a comprehensive evaluation conducted by any mental health professional as a way to understand and diagnose mental health issues. The process typically involves a clinical interview, observation, mental status examination, medical history, and psychosocial testing. The psychiatric interview is considered the most crucial element in the evaluation and care of any person with mental illness. This process is essential in the prediction of the course of the illness, and prognosis as well, and can lead to treatment decisions (Boland et al., 2022). The three major components of the psychiatric interview The psychiatric interview also known as psychiatric history includes historical information relevant to the current clinical presentation. Like any task, the psychiatric interview has three phases, a beginning, a middle, and an end (Carlat, 2017) . Opening and introduction The opening phase includes meeting with the patient and establishing rapport and a comfortable environment. The opening phase is based on careful reinterview preparation and a time to introduce the purpose of the interview and ensure confidentiality also providing an overview of the interview ( Carlat, 2017) History taken During the opening phase, the interviewer comes up with some kind of initial diagnosis hypothesis, the history taken phase is the body of the interview where information about the current symptoms and their onset is gathered, as the individual’s personal history, including family background, relationships, education, and work history are explored. Finally, inquiries about medical history, substance use, and any previous psychiatric treatment to detect if some of those elements are likely problems for a particular patient (Carlat, 2017) . The closing phases The closing phase includes a mental status examination where an evaluation of the patient’s current mental status including mood, affect, thought processes, thought content, perception, cognition insight, assessment of the psychomotor activity, and speech problems are done, along with the identification of the potential risk factors such as suicidal or homicidal thoughts. The other part of this phase includes a discussion of the assessment, using patient education to come to a negotiated agreement about treatment or follow-up plans (Carlat, 2017). The importance of those three components The important of component of the psychiatric interview is that it provides information useful for the psychiatrist, in collaboration with the patient, to develop a person-centered treatment plan (Boland et al., 2022). To interview for diagnosis – without sounding reading off a checklist of symptoms- a clinician must have the skills allowing him/her to memorize the diagnostic and statistical manual of mental health disorders (DSM-5) criteria to use screening and probing questions for each of the major DSM-5 disorders (Carlat. 2017). The establishment of a therapeutic alliance with the patient and the skills to screen for certain DSM-5 disorders are the key to establishing the right treatment plan for a particular patient with a certain mental health disorder

Psychometric properties of the rating scale Psychomotor scales often are used in mental health assessment to evaluate a patient’s motor skills, coordination, and overall physical movements. This assessment can help in assessing various mental health conditions such as depression, mania, and schizophrenia. The rating overall ranges from normal to severely impaired providing information about the patient’s mental status. Many studies have shown the need to identify psychomotor ability and appropriate tests that can assess it (Changiz et al., 2021) The reason why the scale is helpful to a nurse practitioner’s psychiatric assessment The literature introduces psychomotor tests as a tool, a predictor of future professional behavior, and a means to evaluate progress in performance, and academic guidance (ability-oriented medical specialty) (Changiz et al., 2021). The importance of the psychomotor scales is that it can aid in diagnosing mental health conditions by revealing abnormalities in motor activities associated with various disorders such as psychomotor agitation or retardation linked with mood disorders. Another reason is that changes in psychomotor activities can be indicative of the effectiveness or side effects of some psychiatric medications. Understanding a patient’s psychomotor status helps in developing a treatment plan, for instance, interventions may be adjusted to treat hyperactivity, lethargy, or other psychomotor-related symptoms. Finally, the psychomotor scale assessment is a tool used to establish a baseline psychomotor status during the initial assessment to help track changes and make necessary adjustments. (Probst, 2017). The Sheehan Disability Scale (SDS) The Sheehan Disability Scale (SDS) is a self-report instrument designed to assess the functional impairment caused by mental health disorders. is a patient-rated, discretized analog measure of functional disability in work, social, and family life (Sheehan et l., 2008). It’s often used in clinical setting to evaluate the impact of conditions such as anxiety and depression on a person’s daily life. The scale consists of three subscales, each one measures the extend to which a mental health issue interferes with special areas (Sheehan et l., 2008) 1. Work/school: Assess the impact of the mental health condition on the person’s ability to perform tasks related to work or school 2. Social life / leisure activities: Measures the consequences of the mental health on the person’s social life and leisure activities. 3. Family life/home responsibilities: Evaluates the extend to which the mental health condition affects family’s life and the person’s responsibilities. Each subscale is scored on a scale 0 to 10, with higher scores indicating greater impairment. The total score which is the sum of the subscales, will provide an overall measures of functional impairment (Sheehan et l., 2008) References: Boland, R. & Verduin, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.

Carlat, D. J. (2017). The Psychiatric Interview. (Fourth Edition). Wolters Kluwer. Changiz, T., Amouzeshi, Z., Najimi, A., & Adibi, P. (2021). A narrative review of psychomotor abilities in medical sciences: Definition, categorization, tests, and training. J Res Med Sci, 30;26:69. doi: 10.4103/jrms.JRMS_965_19. PMID: 34759986; PMCID: PMC8548887. Probst, M. (2017). Psychomotor therapy for patients with severe mental health disorders. https://www.intechopen.com/chapters/55018 (https://www.intechopen.com/chapters/55018) . Sheehan, K. H., & Sheehan, D. V. (2008). Assessing treatment effects in clinical trials with the Discan metric of the Sheehan Disability Scale. International Clinical Psychopharmacology, 23(2), 70–83. https://doi.org/10.1097/YIC.0b013e3282f2b4d6 ( https://psycnet.apa.org/doi/10.1097/YIC.0b013e3282f2b4d6 )

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