NRNP 6635 WEEK 2 The Psychiatric Evaluation and Evidence-Based Rating Scales

NRNP 6635 WEEK 2 The Psychiatric Evaluation and Evidence-Based Rating Scales

Psychiatric Evaluation and Evidence-Based Rating Scales

The most important component in the assessment and treatment of individuals with mental illness is the psychiatric interview. One of the primary goals of the initial psychiatric interview is to gather information to establish a criteria-based diagnosis. To make well-informed treatment decisions, a criteria-based diagnosis will aid in forecasting the course of the illness and the prognosis (Boland et al., 2022). The three major components of the psychiatric interview are history taking, mental status examination (MSE), and psychiatric formulation. The history-taking portion involves gathering a comprehensive background of the patient, including medical history, psychiatric history, substance use, etc. The patient’s history is crucial to understanding the patient’s current mental state and any influences on their psychiatric health. The MSE assesses the patients’ cognitive, emotional, and psychological functioning. The MSE is essential for identifying any immediate abnormalities in mental functioning for diagnosis and treatment. Finally, the psychiatric formulation synthesizes the information gathered to develop a diagnosis and treatment plan (Voss & Das, 2024).

The components of the psychiatric interview are fundamental because they provide a structured way to assess a patient’s psychiatric health comprehensively. Each element gives a piece of the complete picture of the patient’s mental state. Each component helps the provider accurately diagnose and effectively treat the patient. Furthermore, the elements of the psychiatric interview guide the therapeutic relationship and ongoing monitoring of the patient’s progress.

The Hamilton Depression Rating Scale

The Hamilton Depression Rating Scale (HDRS) is a questionnaire that evaluates the severity of depression in patients already diagnosed with a depressive disorder. The psychometric properties of the HDRS are reliability, validity, sensitivity, and specificity. The HDRS is reliable as providers obtain similar scores when assessing the same patient. The scale has strong validity as it accurately measures the severity of depression. The scale criteria demonstrate validity as they correlate well with other established measures of depression. Lastly, the scale is sensitive to changes in depression severity, which helps with tracking treatment progress. The specificity of the HDRS can be limited as it does not help differentiate between depression and other psychiatric conditions with similar symptoms (Ma et al., 2021).

The HDRS is appropriate to be used when the patient has already been diagnosed with depression or is presenting with depression disorder symptoms. The scale is helpful as part of the initial assessment to gauge the severity of depression at the beginning of treatment. The HDRS is also beneficial for monitoring progress as it reveals changes in the severity of depression. The scale is also helpful for determining if a current treatment plan is effective or needs adjustment. For providers, the HDRS is a valuable tool for psychiatric assessment as it provides a quantifiable measure of depression severity. A provider can utilize the scale results to track the patient’s progress over time, make treatment decisions, and communicate with other providers with a standardized measure of the patient’s depressive symptoms (Rost et al., 2023).

References

Boland, R. & Verduin, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.

Ma, S., Yang, J., Yang, B., Kang, L., Wang, P., Zhang, N., Wang, W., Zong, X., Wang, Y., Bai, H., Guo, Q., Yao, L., Fang, L., & Liu, Z. (2021). The patient health questionnaire-9 vs. the Hamilton Rating Scale for Depression in assessing major depressive disorder. Frontiers in Psychiatry, 12, 747139. https://doi.org/10.3389/fpsyt.2021.747139

Rost, N., Binder, E. B., & Brückl, T. M. (2023). Predicting treatment outcome in depression: An introduction into current concepts and challenges. European Archives of Psychiatry and Clinical Neuroscience, 273(1), 113–127. https://doi.org/10.1007/s00406-022-01418-4

Voss, R. M., & Das, J. M. (2024, April 30). Mental status examination. StatPearls. Retrieved September 2, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK546682/

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The Psychiatric Evaluation and Evidence-Based Rating Scales

Assessment tools have two primary purposes: 1) to measure illness and diagnose clients, and 2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

• American Psychiatric Association. (2022). Section I: DSM-5 basics. In Diagnostic and statistical manual of mental disorders Links to an external site.(5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/full/10.5555/appi.books.9780890425787.Section_1Links to an external site.
• American Psychiatric Association. (2022). Classification. In Diagnostic and statistical manual of mental disorders Links to an external site.(5th ed., text rev., pp.  xiii-xl). https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/full/10.5555/appi.books.9780890425787.Section_1Links to an external site.
  • Review
• Carlat, D. J. (2024). The psychiatric interview (5th ed.). Wolters Kluwer.
  • Chapter 35, Writing Up the Results of the Interview
• Boland, R. & Verduin, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.
  • • Chapter 1, “Examination and Diagnosis of the Psychiatric Patient”
• American Academy of Child and Adolescent Psychiatry (1995). Practice parameters for the assessment and treatment of children and adolescentsLinks to an external site.. 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 adultsLinks to an external site. (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 PsychiatryLinks to an external site. (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 PsychiatryLinks to an external site. (4th ed., pp. 39–52). 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 PsychiatryLinks to an external site. (4th ed., pp. 16–21). Wolters Kluwer.

Required Media

• Classroom Productions. (Producer). (2015). Diagnostic criteria Links to an external site.[Video]. Walden University.
• MedEasy. (2017). Psychiatric history taking and the mental status examination | USMLE & COMLEXLinks to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=U5KwDgWX8L8
• Psychiatry Lectures. (2015). Psychiatry lecture: How to do a psychiatric assessmentLinks to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=IRiCntvec5U

To Prepare:

• Review this week’s Learning Resources and reflect on the insights they provide regarding psychiatric assessment and diagnosis.
• Consider the elements of the psychiatric interview, history, and examination.
• Consider the assessment tool assigned to you by the Course Instructor.

By Day 3 of Week 2

Post a brief explanation of three important components of the psychiatric interview and why you consider these elements important. Explain the psychometric properties of the rating scale you were assigned. Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.

Upload a copy of your discussion writing to the draft Turnitin for plagiarism check.  Your faculty holds the academic freedom to not accept your work and grade at a zero if your work is not uploaded as a draft submission to Turnitin as instructed.

Read a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond to at least two of your colleagues on 2 different days by comparing your assessment tool to theirs.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

NRNP_6635_Week2_Discussion_Rubric