Psychiatric Evaluation & DSM

These flashcards cover important concepts related to psychiatric evaluation and the DSM-5-TR, including objectives, the psychiatric interview process, the Mental Status Examination, and cultural considerations.

What is the overall purpose of a psychiatric interview?

form a hypothesis about the etiology

foster an alliance with the patient

What is the mental status exam (MSE)?

structured clinical assessment that uses interviewing techniques and observational skills to identify psychological function of a patient

What is the purpose of the MSE?

evaluate current mental status

How does the depth of the MSE compare to the psychological assessment?

MSE: focused

Psychological: extensive and comprehensive

What can impact the performance of the MSE?

culture, native language, education, social factors

What additional parts of the history should be obtained with a psych complaint?

psychiatric history

early environment

education and occupation

values and coping mechanism

What objective things should be assessed by the clinician in the MSE?

appearance, attitude, behavior

mood and affect

perceptual disturbances

though formation and content

cognition and sensorium

insight and judgement

What are indications for a comprehensive MSE?

patient is in the emergency room or crisis clinic

older than 60

history of psych disorder

personal habits and memory have rapidly deteriorated

exam suggests brain dysfunction

What are limitations of MSE?

subjective assessment; results vary between clinicians

patient trust is essential

intellectual disability or neuro disorders may require response interpretation

What is a psychological assessment?

comprehensive eval of psychological functioning, personality, and cognitive abilities using standard testing

Who performs MSEs and psychological assessments?

MSE: medical and mental health clinicians

Psych Assessment: psychologists

What are the components of a psychological assessment?

psychological tests

interviews

behavioral observations

record review

What is the purpose of a psychological assessment?

evaluate overall psychological functioning

How does the output of the MSE compare to the psychological assessment?

MSE: clinical note

Psych Assessment: formal psych report

What is the purpose of the DSM-5?

standardize diagnoses, aids in diagnosing and treating conditions, and serves as a framework for research

What diagnosis was added to the DSM in the DSM-5-TR?

prolonged grief disorder

What are components of DSM Section 1?

introduction

use of the manual

cautionary statement for forensic use

What are components of DSM Section 2?

disorders listed by diagnostic category

criteria sets for each disorder

What are examples of diagnostic categories in the DSM?

neurodevelopmental disorders

schizophrenia spectrum

other psychotic disorders

mood disorders

anxiety disorders

What are components of the criteria sets in the DSM?

specific symptoms, duration, severity requirements

What are components of DSM Section 3?

assessment measures

cultural formulation

alternative DSM5 model for personality disorders

conditions for further study

What are limitations of the DSM-5?

over-diagnosis and over-medicalization

reliability and validity issues

pathologizing normal behavior

cultural bias

comorbidity

lack of biological markers

What is the cultural formulation section in the DSM5?

guides clinicians in assessment of cultural context of a patient’s mental health concerns

includes narrative guidance and semi-structured cultural formulation interview

What is the purpose of the cultural formulation interview?

enhance diagnostic accuracy

improve patient-clinician communication

reduce misdiagnosis or over-pathologizing

guide culturally appropriate treatment planning