General Principles Of Psychiatric Interviewing

Goals

There are three main goals of psychiatric assessment. 

1. The aim is to arrive at a diagnosis that aids in prognosis and serves as a foundation for logical, evidence-based treatment.
2. Understanding the diagnosis's context is the second objective.
Comprehending the individual's biopsychosocial aspects is also crucial. To comprehend the disease, sufficient details about the patient's personality, past medical history, and present circumstances must be known. It affects prognosis and management as well.
3. Developing a therapeutic alliance or rapport is the third objective. The ability of a doctor and patient to respond to each other in a harmonious manner is known as rapport. Accurate and comprehensive history taking is crucial, as is involving patients completely in the discussion of management and treatment compliance.

Supportive care is provided. Establishing a therapeutic relationship, understanding the context of the diagnosis, and making a diagnosis are the main objectives of the psychiatric examination.

Process Of Psychiatric Assessment

The process of psychiatric assessment is done by psychiatric interviewing. 

General Principles Of Psychiatric Interviewing

1. Contacts and interview prior to the interview

Prior to the interview, all of the patient's information should be verified. For instance, patient information should be referenced to the emergency paperwork if the patient moves from the emergency room to the ward. However, since the patient might not have provided all the facts, the interview should be conducted impartially and with an open mind as a result of the prior documentation gathered.

2. Preparing for the first meeting

The physician has the duty to ensure that the patient feels comfortable throughout the consultation. It is important to make sure the interview location is secure and patient privacy is respected.

If the interview lasts too long, the patient may become agitated and lose focus. Therefore, it is important to make sure they understand the nature and goal of the meeting, whether it is a screening or a thorough assessment. It is best to reduce potential sources of distraction during the interview, such as cell phones and large crowds of people.

3. Comfort and Safety

 It's critical to preserve patient comfort and make sure that the doctors and the patient are in a safe location, such as close to an exit door or among others, so that assistance may be called for in an emergency.

4. Confidentiality and Privacy

The patient frequently divulges information to others that he would not normally reveal. Therefore, it's critical to protect the patient's privacy and confidentiality.

5. Involvement of Third Parties

 In mental health instances, the informant's family member may potentially provide information. It is important to get the informant's permission before involving family members, and to talk about the information that will be disclosed about them.

6. Engagement and relationship-building

 In order for the patient to feel comfortable sharing information, there should be a solid rapport between the doctor and the patient.

7. Significance and correspondence

Both the patient and the psychiatrist are affected by the conscious and unconscious processes. These procedures should be taken into consideration since they may have an impact on the psychiatrist's and patient's emotions and behaviors.

Questions with an Open or Closed End

Open-ended inquiries let the patient answer in whatever way they choose and are meant to elicit a spirit of curiosity. "What can you tell me about your feelings in the past few days?" is one example of a question. and the patient is free to respond with as much information as they like to

Open-ended inquiries, on the other hand, typically require a YES or NO response. For instance, the patient responds with a YES or a NO when asked if they have been depressed in the last several days.
In order to obtain the essential information, it is preferable to ask more open-ended questions early in the interview. However, you might also need to ask some closed-ended questions later on.

9. Disorder-based and person-centered

To identify signs and symptoms for diagnosis, the interview should be disorder-based and patient-centered, emphasizing the patient's strengths and weaknesses.

10. Duration and number of sessions

The duration of a session may vary depending on whether or not it is a comprehensive review. Typically, a thorough evaluation takes between 45 and 90 minutes, or at least an hour. These times may change based on the clinical expertise. It is possible that a highly qualified psychiatrist will need less time for evaluation—roughly 15 to 20 minutes. To gather all pertinent data in an emergency situation.

The screening and follow-up may take less time because the psychiatrist already knows all of the patient's information.  The procedure of psychiatric interviews is dynamic, and examinations are continuous. It's possible that the history won't be covered in one interview, thus more than one session might be needed to get all the material.

Also Read: Management Of Alcohol Use Disorder

Hope you found this blog helpful for your Psychiatric Theory and Specialities Preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.