1 day ago
Benjamin Miller
WK 2 Discussion – AIMS
COLLAPSE
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The Psychiatric Evaluation and Evidence-Based Rating Scales
The Psychiatric Evaluation
The three most important components for the psychiatric interview are building a therapeutic relationship, history of present illness, and if they are currently suicidal (Carlat, 2017). Carlat (2017) talks about the importance of warmth, empathy, and relationship building is and can be the reason a patient continues treatment or drops out. If a patient doesn’t have trust or rapport with the clinician, their commitment to treatment will be lost in the first interview (Carlat, 2017).
History of present illness, or HPI, is also very important and is considered the most important part of the evaluation by Carlat (2017). If a new client has been diagnosed and treated for a disorder for 20 years, knowing what has worked or failed in the past is essential to avoid repetition. If a patient presents with a depressed mood, knowing the cause of depression could direct your treatment options.
The most important part of a psychiatric evaluation is current suicidal ideations or desire to be dead. This answer to this question could be the difference between discharge, voluntary admission, or an involuntary hold. Knowing risk factors for suicide and warning signs will help you assess if the patient is at imminent risk or not (Carlat, 2017).
Evidence-Based Rating Scale
The evidence-based rating scale assigned was the Abnormal Involuntary Movement Scale or AIMS. The Abnormal Involuntary Movement scale is the screening tool used to look for the abnormal movements of Tardive Dyskinesia caused by dopamine receptor blocking agents in antipsychotics. Gebhardt et al. (2008) found the AIMS assessment to be both reliable and valid. As a psychiatric nurse practitioner, it will be likely to care for a schizophrenic, as 1% of the population will develop schizophrenia in their lifetime (Sadock et al., 2015). Schizophrenia is commonly treated with antipsychotics and up to 20% of those treated with antipsychotics for over a year develop Tardive Dyskinesia or TD (Sadock et al., 2015). Newly diagnosed schizophrenics taking antipsychotics typically do not show signs of TD for at least six months (Sadock et al., 2015). This shows the importance of the HPI in the psychiatric interview and knowing past diagnoses and treatment for schizophrenia (Carlat, 2017).
References
Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer.
Gebhardt, S., Härtling, F., Hanke, M., Theisen, F. M., von Georgi, R., Grant, P., . . . Remschmidt, H. (2008). Relations between movement disorders and psychopathology under predominantly atypical antipsychotic treatment in adolescent patients with schizophrenia. European Child & Adolescent Psychiatry, 17(1), 44-53. http://dx.doi.org/10.1007/s00787-007-0633-0
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
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Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.–
Excellent 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings.
Responds to questions posed by faculty.
The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.
Good 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting.
Fair 7 (7%) – 7 (7%)
Response is on topic, may have some depth.
Poor 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.
Second Response:
Writing–
Excellent 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues.
Response to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in Standard, Edited English.
Good 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues.
Response to faculty questions are mostly answered, if posed.
Provides opinions and ideas that are supported by few credible sources.
Response is written in Standard, Edited English.
Fair 4 (4%) – 4 (4%)
Response posed in the discussion may lack effective professional communication.
Response to faculty questions are somewhat answered, if posed.
Few or no credible sources are cited.
Poor 0 (0%) – 3 (3%)
Responses posted in the discussion lack effective communication.
Response to faculty questions are missing.
No credible sources are cited.
Second Response:
Timely and full participation–
Excellent 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation.
Posts by due date.
Good 4 (4%) – 4 (4%)
Meets requirements for full participation.
Posts by due date.
Fair 3 (3%) – 3 (3%)
Posts by due date.
Poor 0 (0%) – 2 (2%)
Does not meet requirements for full participation.
Does not post by due date.
American Academy of Child and Adolescent Psychiatry (1995). Practice parameters for the assessment and treatment of children and adolescents. https://www.aacap.org/App_Themes/AACAP/docs/practice_parameters/psychiatric_assessment_practice_parameter.pdf
American Psychiatric Association. (2016). Practice guidelines for the psychiatric evaluation of adults (3rd ed.). https://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2017). Classification in psychiatry. In Kaplan and Sadock’s Concise Textbook of Clinical Psychiatry (4th ed., pp. 1–8). Wolters Kluwer.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2017). Psychiatric interview, history, and mental status examination. In Kaplan and Sadock’s Concise Textbook of Clinical Psychiatry (4th ed., pp. 9–15). Wolters Kluwer.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2017). Medical assessment and laboratory testing in psychiatry. In Kaplan and Sadock’s Concise Textbook of Clinical Psychiatry (4th ed., pp. 16–21). Wolters Kluwer.
Required Media (click to expand/reduce)
Classroom Productions. (Producer). (2015). Diagnostic criteria [Video]. Walden University.
MedEasy. (2017). Psychiatric history taking and the mental status examination | USMLE & COMLEX [Video]. YouTube. https://www.youtube.com/watch?v=U5KwDgWX8L8
Psychiatry Lectures. (2015). Psychiatry lecture: How to do a psychiatric assessment [Video]. YouTube. https://www.youtube.com/watch?v=IRiCntvec5U
American Psychiatric Association. (2013). Section I: DSM-5 basics. In Diagnostic and statistical manual of mental disorders (5th ed., pp. 5–29). Author.