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  • Image not available. Patients with psychiatric conditions are treated in all healthcare settings. All clinicians need to develop basic skills in psychiatric assessment to provide the best care for their patients.
  • Image not available. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) is the most widely accepted diagnostic reference. It, along with the American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults, provides the clinician a standardized approach for the initial assessment and follow-up of patients with mental illness.
  • Image not available. At times, patients suffering from mental illness are challenging to assess, as their condition can prevent them from full cooperation. A range of strategies can be used to gather the needed information while maintaining the safety and comfort of both patient and clinician.
  • Image not available. A thorough medication history to identify all medications currently taken, as well as those previously taken, is a cornerstone of effective patient management. In addition, it must be determined whether there was an adequate trial (dose and duration) of current and prior medications for psychiatric illnesses.
  • Image not available. A baseline mental status examination, along with a specific target symptom list, is a critical tool in monitoring response to treatment.
  • Image not available. Several papers have been published in recent years recommending specific physical assessment and laboratory tests needed for the evaluation of patients with psychiatric conditions. Except for patients taking antipsychotics, no single standard exists, and testing is individualized based on the patient's age, medical history, current physical health, and current medication use; and in consideration of the most recent expert opinion.
  • Image not available. Baseline and follow-up monitoring for metabolic disturbances should be instituted for all patients taking antipsychotics.

Upon completion of the chapter, the reader will be able to:

  • 1. Describe the purpose of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and how it is used in the clinical care of patients with mental illness.
  • 2. Construct a multi-axial evaluation to describe a patient’s diagnosis and any potential factors contributing to their presentation.
  • 3. List the components of a mental status examination and describe the information that each section provides to the clinician.
  • 4. Describe how to initially approach a patient and conduct a clinical interview.
  • 5. Develop an interview plan that will collect specific information to describe a patient’s mental status.
  • 6. Identify information from a psychiatric, medical, and medication history that is relevant to the evaluation of a patient with a specific mental illness.
  • 7. Interpret the information gathered from a mental status examination; psychiatric, medical, and medication histories; and a medical assessment to construct a problem-focused workup.
  • 8. Describe the role of medical testing in the diagnosis and monitoring of patients with psychiatric illness.
  • 9. Recommend a monitoring plan to identify and manage metabolic complications secondary to antipsychotic therapy.
  • 10. List at least three advantages and three limitations associated with psychiatric rating scales used to assess mental status, psychiatric symptoms, and medication-induced adverse effects.
  • 11. Define the following terminology associated with clinical rating scales: sensitivity, ...

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