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Psychiatric Evaluation. Unless otherwise indicated, all answers are from the Practice Guideline on this topic, AJP Supplement, June, 2006 As of 11Sep08. Limited English Proficiency. Q. What about the use of family members when working with a pt with limited English proficiency?.

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Psychiatric evaluation

Psychiatric Evaluation

Unless otherwise indicated, all answers are from the Practice Guideline on this topic, AJP Supplement, June, 2006

As of 11Sep08

Limited english proficiency
Limited English Proficiency

Q. What about the use of family members when working with a pt with limited English proficiency?

Limited english proficiency1
Limited English Proficiency

Ans. To be avoided unless pt refuses to allow interpreters or under emergency conditions. Be sure to so note the use of family members in the note and the reason why they were used.

Comprehensive and accurate information
Comprehensive and accurate information

Q. Under what circumstances will one obtain the most comprehensive and accurate information in the initial interview?

Comprehensive and accurate
Comprehensive and accurate

Ans. Combination of:

1] Open-ended questions with empathy

2] Structured inquiry about specific symptoms and events.

Agitated pt room
Agitated pt -- room

Q. Desirable interview room arrangement with an agitated pt?

Agitated pt room1
Agitated pt -- room


1] both have access to door

2] several arm lengths space between pt and examiner

3] no dangerous objects in the room

4] a mechanism for asking for assistance

5] no personal objects that can be used by pt to harm examiner, e.g. necktie.

Agitated pt affect management
Agitated pt – affect management

Q. What does affect management consist of?

Agitated pt affect management1
Agitated pt – affect management


1] Allow pt to ventilate

2] Avoid logical responses that are likely to inflame

3] Validate the affect.

Agitated pt suggesting dangerousness
Agitated pt – suggesting dangerousness

Q. What are some things to watch for as to signs the interview is getting more dangerous?

Agitated pt signs suggesting dangerousness
Agitated pt – signs suggestingdangerousness


1] restlessness increasing

2] desire to pace

3] clenched fists

4] increased voice tone

5] threatening content of speech

Beck v hamilton
Beck v. Hamilton

Q. How does the Beck Depressive Inventory differ from the Hamilton Depression Rating as to self-reporting?

Beck v hamilton1
Beck v. Hamilton

Ans. Unlike the Hamilton, the Beck can be self-reported by the pt.


Q. What is the PANSS?


Ans. Measures positive and negative signs of schizophrenia.

Neuropsychological testing
Neuropsychological testing

Q. What are uses of neurological testing?

Neuropsychological testing1
Neuropsychological testing

Ans. “Clinical judgment” as to whether to so request. Not part of any DSM-IV criteria. May be helpful with:

1] Need to grade cognitive deficits or follow the progression of those deficits.

2] Differential dx with malingering or factitious disorders – or other psychiatric disorders.


Q. What is HIPAA?


Ans. Health Insurance Portability and Accountability Act.

Hipaa fed v state
HIPAA: fed v. state

Q. Under HIPAA, what is status of state laws that are more restrictive than HIPAA?

Hipaa feds v state
HIPAA: feds v. state

Ans. More restrictive state law takes precedent.