Psychiatric Interview / Assessments, Tools & Forms Flashcards by Korey koper

specifically designed tasks used to measure a psychological function known to be linked to a particular brain structure or pathway.

Neuropsychological testing

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Neuropsychological testing examples ?

Intelligence

Memory

Language

Exec Function

Visuospacial

Dementia specific

Battery tests

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Where to Get the Information?

PCP ….. and others

Family

Past therapists

Patient

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Psychiatric Interview outcome depends on ?

outcome depends on the situation ( ER versus office ( more appropriate))

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Psychiatric Interview: In psychiatry often the lack of definition forces the exercise of _______ _______.

practical wisdom

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Psychiatric Interview: Every encounter is ?

therapeutic

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Psychiatric Interview: “…therapy is a kind of rhetoric in which you stimulate emotional arousal to ?”

transform the meaning of an event…

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Psychiatric Interview: That transformation can occur only if you can offer the patient a conceptual framework for ___________ of his [or her] maladaptive assumptions…

making sense

**asking questions to provoke thought **

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Psychiatric Interview: If accurately applying the DSM-5 diagnostic criteria in all their specify is the _______ of psychiatric interviewing, then the ___ if forming a therapeutic alliance…”

science

art

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Psychiatric Interview: in an effective diagnostic interview, you conduct a form of rudimentary psychotherapy in which ____________ and provide appropriate support to a demoralized patient…

you instill hope

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Psychiatric Interview: your ability to form an _______ however will be shaped by a person’s past experiences”

alliance

Emergency department (new) vs established pt
Prior psych history
Current mental state

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Model _____ and _____ to your patients

empathy and warmth

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Psychiatric Interview: remember ?

You have no idea of the challenges they experienced and chances are you have never even come close to experiencing the pain they have experienced

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Act like an __________ uncovering the complex history of a patient

anthropologist

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Setting the tone – the environment ?

Lighting

Arrangement of office setting i.e. facing the patient or facing a computer

Talk from waiting room to the office

Note: Your seating position -> closest to the door for rapid egress if needed

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Starting the dialog, example ?

Hi, I’m Steven and a Physician Assistant here at the clinic. I read your chart but I would like to know more about you…

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The 30-Minute Interview adapted from ?

The Pocket Guide to the DSM-5 Diagnostic Exam

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Minute 1: Introduction ?

“Hi my name is…”

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Minute 2-4: Listen ?

Don’t talk unless you need to guide

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Minute 5-12: Ask ?

HPI (History of Present Illness)

PPH (Past Psych History)

Safety (Suicidal or Homicidal Ideation

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Minute 13-17: ROS ?

Mood
Psychosis
Anxiety
Obsessions and Compulsions
Trauma
Dissociation
Somatic Concerns
Eating 
Sleeping
Substance and other Addictions
Personality
Elimination

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Minute 18-23: PMH ?

Allergies

FH, SH

Developmental Hx

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Minute 24-28: Mental status examinations ?

MMSE

PHQ

GAD-7

etc…

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Minute 29-30: Follow-up and closure ?

close up

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Minute 1 ?

Introduction

Minute 2-4 ?

Listen

Minute 5-12 ?

Ask

Minute 13-17 ?

ROS

Minute 18-23 ?

PMH

Minute 24-28 ?

Mental Status Examinations

Minute 29-30 ?

Follow-up and Closure

Presenting the Patient: Psychiatry is _____ _________ and creating a story that includes evidence of the patients condition

pattern recognition

Presenting the Patient: Tell it as a story, just as you do for other medical presentations ?

Name Age Gender Chief complaint with patient quote if appropriate

Presenting the Patient: Tell it as a story, just as you do for other medical presentations ?

HPI (using DSM criteria) ROS Past Psych Hx Past Medical Hx Family Hx Developmental Hx Social Hx

Presenting the Patient: Tell it as a story, just as you do for other medical presentations ?

Testing results (i.e. MMSE) Differential Diagnosis Assessment Plan: - Additional Tests/Treatment - Medication - Education - Safety - Nutritional * Prognosis

Diagnostic Rating Scales identify what ?

Identify specific psychiatric disorders in epidemiological studies and large scale clinical trials

Diagnostic Rating Scales examples ?

- The Present State Examination - The Composite International Diagnostic Interview - The Diagnostic Interview Schedule

Symptom-Based Scales measure ?

change in a particular symptom or a syndrome-based group of symptoms

Symptom-Based Scales are completed by who ?

patient

Symptom-Based Scales examples ?

The Brief Psychiatric Rating Scale The Hamilton Rating Scale for Depression The Beck Depression Inventory Zung Depression Scale

The Brief Psychiatric Rating Scale ?

psychotic and no psychotic issues - evaluation of baseline measures

The Hamilton Rating Scale for Depression ?

most widely used more so assess sxs. of depression nd if it progressivee over time

The Beck Depression Inventory ?

self rating and used to evaluate depression - feedback from patient how the tx. is going

Zung Depression Scale ?

self rating and used to evaluate depression - feedback from patient how the tx. is going

Neuropsychological assessment completed by ?

Neuropsychologist

Neuropsychological assessment: Acquire data about a subject’s ?

Cognitive Motor Behavioral Linguistic Executive functioning

Neuropsychological assessment topics / examples ?

``` CAGE SMAST DAST-10 GAD-7 PHQ-9 AUDIT (self and clinician versions) MMSE ```

What is CAGE ?

is a brief, 4-item questionnaire used for the routine and rapid screening of alcohol problems

CAGE acronym ?

Feeling the need to Cut down, Becoming Annoyed at criticism Feeling Guilty about drinking Needing a drink first thing in the morning to get going, Eye-Opener

CAGE specificity and sensitivity ?

Specificity of 76% Sensitivity of 93%

SMAST aka ?

Short Michigan Alcohol Screening Test * *(note FYI - there are 3 different versions) * *

SMAST: Each of these are __ item measures about problems experienced by the indicated person as a result of __________.

13 drinking alcohol

SMAST sensitivity and specificity ?

Sensitivity of 48% Specificity of 100% (several caveats to these results)

DAST-10 aka ?

Drug Abuse Screening Test

DAST-10 sensitivity and specificity ?

Sensitivity: 80-85% Specificity: 78-88%

DAST-10: _______, yes/no self-report Drug Abuse Screening instrument that has been condensed from the ______ DAST and should take less than _ minutes to complete.

10-item 28-item 8

DAST-10: Designed to provide a brief instrument for clinical screening and treatment evaluation and can be used with ?

adults and older youth

GAD-7 aka ?

Generalized Anxiety Disorder 7

Generalized Anxiety Disorder 7 is a ____-_______ questionnaire for screening and severity measuring of __________ ________

self-reported generalized anxiety

GAD-7 has _____ items, which measure severity of various signs of ________________ according to reported response categories

seven generalized anxiety disorder

GAD-7: Assessment is indicated by the total score, which made up by adding ?

together the scores for the scale all seven items.

GAD-7 is a sensitive self-administrated test to assess generalized anxiety disorder, however it cannot be used as replacement for ?

clinical assessment

GAD-7 sensitivity and specificity ?

Sensitivity (89%) Specificity (82%)

GAD-7: Increasing scores on the scale were strongly associated with multiple domains of ?

functional impairment

PHQ-9 aka ?

Patient Health Questionnaire 9

The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the ?

severity of depression

___________ on the PHQ-9 screens for the presence and duration of suicide ideation

Question 9

PHQ-9 was established in studies involving __ primary care and __ obstetrical clinics

8 7

PHQ-9 sensitivity and specificity ?

Sensitivity of 88% Specificity of 88% for major depression

AUDIT aka ?

The Alcohol Use Disorders Identification Test

AUDIT: This ___________________ can help determine whether a patient might have problems with _____________.

10-question screening test drinking alcohol

AUDIT sensitivity and specificity ?

Sensitivity 70.1% Specificity 95.2% (some caveats to this depending on the population being tested)

MMSE aka ?

Mini Mental State Examination

The Mini Mental State Examination (MMSE) is the most commonly used test for complaints of ________ ______

memory problems

MMSE: It can be used by clinicians to help diagnose ________ and to help assess its ?

dementia progression and severity

The _____ is a series of questions and tests, each of which scores points if answered correctly.

MMSE

MMSE: If every answer is correct, a maximum score of __ points is possible.

The MMSE tests a number of different mental abilities, including a person's ?

memory attention language.

Whats the cause ? it can be ?

Organic(“Do a Psych Eval”) Psychiatric (“Medically Clear The Patient”) Chronic Transient Environmental Social Financial Long list **has it just began of few days or have they had these between months and years **

Psychiatric Interview / Assessments, Tools & Forms Flashcards

(79 cards)