Assignment:Psychiatric Examination Assessment Tools

Assignment:Psychiatric Examination Assessment Tools

Assignment:Psychiatric Examination Assessment Tools

Psychiatric Examination Assessment Tools

Different psychiatric examination assessment tools are used to examine a patient’s mental health (Roberts, 2019). For instance, Mini-Mental State Examination (MMSE), General Health Questionnaire (GHQ), Insomnia Severity Index (ISI), Depression, Anxiety and Stress Scale (DASS-21), Generalized Anxiety Disorder (GAD-7), and Patient Health Questionnaire (PHQ) for Depression. The tools aid in making appropriate diagnosis and giving the correct care.

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Part One

Components of Psychiatric Interview

 Psychiatric interviews help manage patients presenting with mental health conditions. The three important components of a psychiatric interview include the chief complaints and history of presenting illness, past psychiatrist and medical history, and mental state exams (Roberts, 2019). Mental health patients are normally managed by a psychiatrist, who, after thorough evaluation and examination, makes a diagnosis and formulates the treatment plan for the patients (Geddes&Andreasen, 2020). The components of psychiatric interviewsare essential since they signal the psychiatrist of the potential causes of mental health problems in the patients.

Why the Elements are Important

The chief complaints and the history of presenting illness provide helpful information about the signs and symptoms and their progress fromthe onset. It is important is assessing the severity, frequency, treatment response, and any exacerbating and relieving factors (Roberts, 2019). Past psychiatric and medical history is important because it shows if there was any past psychiatric illness and the response to drugs. It also highlights if specific causes, such as head trauma, convulsions, and past cardiovascular conditions, might have caused the current situation(Roberts, 2019). The MSE is very important in every psychiatric patient as it helps the psychiatrist to elicit signs and symptoms from the patient useful in making a diagnosis.

Psychometric Properties of MMSE

MMSE is a psychiatric tool used mostly for clinical examination of cognitive impairment. The tool can quickly assess the level of cognitive impairment by evaluating the answers the patients provided based on the questions asked (Ciolek& Lee, 2019). It has a total of six areas assessed to measure the cognitive ability of an individual. The standard MMSE has a maximum score of 30. A score of 25 and above is considered normal, while a score of below 24 may suggest possible cognitive impairment.

The psychiatrists must be present and systematically review the questions with the patient during the examination.The reliability and internal consistency level are moderately high when performing MMSE in patients with cognitive impairment (Ciolek& Lee, 2019). MMSE has a cut-off score of 27, sensitivity of 79%, and specificity 0f 95%; therefore, it assists in diagnosing cognitive impairment. Due to its high sensitivity and specificity should be widely used in clinical evaluation to establish cognitive impairment, especially in older patients. 

When to Use MMSE Assessment Scale during Psychiatric Interview

 It is appropriate to use MMSE Assessment Scale to assess the cognitive functions of the patient. MMSE enables the psychiatrist to take the shortest time possible since the questions are well-structured and logical. In patients suspected to be suffering from dementia, MMSE helps in confirming the diagnosis due to its high specificity and sensitivity. Patients with short-delay recall can quickly be evaluated with MMSE. The MMSE evaluation score should take into consideration of the education level and age of the patient when interpreting the score since they have an impact on the score. 

The Usefulness of the MMSE Scale to Nurse Practitioner’s Psychiatric Assessment

 Firstly, the scale enables nurses to diagnose patients, especially elderly patients, with cognitive impairment. The tool is easy to use and does not require much effort besides making the patient comfortable and recording the responses. In a language barrier, the nurse practitioner can quickly get assisted by a language translator (Davies, 2023). The rating scale also enables the nurse in psychiatrist assessment to evaluate the patient outcome based on previous presentations and see if there are any improvements. By so doing, the nurse can decide to increase or decrease the medication administered. Finally, a nurse practitioner can also use the scale if they suspect that confusion in a patient may be due to head trauma or infectious processes.

Part Two

Comparison between MMSE and Abnormal Involuntary Movement Scale

MMSE is a scale used to evaluate a patient’s mental status to identify cognitive disorders such as dementia and assess confusion. In contrast, the Abnormal Involuntary Movement Scale is used to evaluate dyskinesia severity (Bastos et al., 2021).

Comparison between MMSE and Patient Health Questionnaire (PHQ-9)

PHQ-9 is used to evaluate depression in patients compared to cognitive assessment in MMSE. It has nine item parts, while MMSE has six item parts. The total score in PHQ-9 is 27, while in MMSE is 30 (Liguori et al., 2018). Both scales can be used in any population.

Conclusion

Psychiatric examination is important indiagnosing mental health problems. Different mental health conditions can be assessed using various psychiatric assessment tools.Correct evaluation of the elements of psychiatric interviewsand the application of psychometric properties of MMSE is essential and helps psychiatrists properly manage the patient.

References

Bastos, M. S., Nickel, R., Camargo, C. H., &Teive, H. A. (2021). Patients with cervical dystonia demonstrated decreased cognitive abilities and visual planning compared to controls. Movement Disorders Clinical Practice, 8(6), 904-910. https://doi.org/10.1002/mdc3.13259

Ciolek, C. H., & Lee, S. Y. (2019). Cognitive issues in the older adult. Guccione’s Geriatric Physical Therapy E-Book, 425.

Davies, T. L. (2023). Tailoring the mental health assessment to older adults. The Nurse Practitioner, 48(1), 10-18. https://journals.lww.com/tnpj/Fulltext/2023/01000/Tailoring_the_mental_health_assessment_to_older.4.aspx

Geddes, J. R., &Andreasen, N. C. (2020). New Oxford textbook of psychiatry. Oxford University Press, USA.

Liguori, C., Pierantozzi, M., Chiaravalloti, A., Sancesario, G. M., Mercuri, N. B., Franchini, F.,&Sancesario, G. (2018). When cognitive decline and depression coexist in the elderly: CSF biomarkers analysis can differentiate Alzheimer’s disease from late-life depression. Frontiers in aging neuroscience, 10, 38.

Roberts, L. W. (Ed.). (2019). The American Psychiatric Association Publishing Textbook of Psychiatry.American Psychiatric Pub.

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PART ONE

Post a brief explanation of three important components of the psychiatric interview and why you consider these elements important.

Explain the psychometric properties of the Mini-Mental State Examination scale (MMSE).

Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.

PART TWO

Compare the mini-Mental state Examination (MMSE) Scale to the Abnormal Involuntary Movement Scale (AIMS)

Compare the Mini-Mental Examination (MMSE) scale to the Abnormal Involuntary Movement Scale (AIMS)