DISCUSSION BOARD POST

PLEASE RESPOND TO MY CLASSMATE DICUSSION POST

The goal of a psychiatric interview is to describe the patients complaints, appearance, and existence in an actionable psychopathological format. The format results in diagnostic classification and other clinical decisions. Psychiatric interview helps obtain pertinent information and assist in determining the most accurate diagnosis for the patient by identifying biopsychosocial factors to create a patient specific plan (Sadock et al., 2015). When conducting a psychiatric interview there are many crucial components that should never be ignored. “The purpose of a psychiatric interview is to establish a therapeutic relationship with the patient to collect, organize and formulate a differential diagnosis and treatment plan” (Gibbs, 2020). It is crucial to take into consideration that a patient may be tensed. This may be their first time psychiatric assessment. Also, they may be in a state of mind where they feel they do not need to see a professional, they may be doing it because their family has asked them to. It is important to make the patient feel like they are not being judged. In order for the patient to open up it is important to remain non-biased and approachable. If a patient feels like they are being judged they may shut down completely.

Three important components of the psychiatric interview I consider important are:

Asking about patient about suicidal ideation feeling: Finding out if the patient is having suicidal ideations or homicidal ideation is a key part of a psychiatric interview. If during the interview it is revealed that the patient is having suicidal ideations, then appropriate steps can be taken to keep the patient safe. finding out all types of hallucinations is paramount during psychiatric interview.
Asking about Past psychiatric history and medication: A vital component of a psychiatric interview is for the PMHNP to obtain information about past psychiatric diagnoses
and medication patient is using. Asking about present and past medication is crucial because it allows the PMHNP to formulate a differential diagnosis. Besides, knowing about the previous psychiatric and treatment can help the PMHNP determine which treatment options the patient has tried in the past including the patient response to such treatment regimen, side effects, and adherence (American Psychiatric Association, 2020). The PMHNP should give priority to issues of past suicidality intent, ideation, plan, and attempt mentioned by the patient or his or her family.

Family and developmental/substance abuse history: it is very critical since most of the psychiatric conditions run in families. The genetic and environmental situation of an
individual needs to be assessed to enhance accurate diagnosis and treatment. The history include parents, grandparents, siblings and other blood relative (Bjorklund, 2013).

The tool that I have been assigned this week is the Brief Psychiatric Rating Scale (BPRS). Brief Psychiatric Rating Scale (BPRS) is a psychiatric symptom rating scale. its designed to monitor change in symptoms so each item is ranked on a scale of zero to seven. The higher the value the more severe the symptomatology. This scale has been validated and certain scores correspond with mild illness, moderate illness, severe illness etc. psychometric properties in terms of reliability, validity and sensitivity have been extensively examined. It is one of several tools that can be used in the diagnosis of people with schizophrenia and related psychotic disorders (Yee et al., 2017). BPRS is use it to track any changes in symptoms over time. The version most usually used includes 24 items which assesses different symptom of schizophrenia and a shorter version which assess only 18 symptom items. Symptoms usually assessed include: somatic concerns (concerns about your physical health), anxiety, depression, suicidality (suicidal feelings or attempts), guilt, hostility, elated mood, grandiosity (identifying as rich, famous, or having special.

BPRS should be administered by a clinician who is knowledgeable concerning each of the system domains and severe mental health disorders. It can be used during the psychiatric interview to help assess a patient’s mental status, depending on how the questions are worded. The BPRS is helpful to PMHNP because it provides a quick snapshot of a client’s current mental status, allowing the nurse practitioner to quickly and efficiently asses the current state of the client’s mental health.

The BPRS is often used during the psychiatric interview to determine the most appropriate care plan for the client and provides a valuable tool for the psychiatric assessment. The BPRS was originally intended to be a questionnaire with a series of yes/no questions about a patient’s current mental state. However, the BPRS has evolved over the years to include a series of statements which the doctor reads out to their patient, who then indicates how well each statement applies to them. This allows the doctor to get a better picture of their patient’s current mental state (Wolters., et al 2017).

BPRS works by the PMHNP asking the client specific questions or looks for certain behaviors. The PMHNP get a series of ratings based on client’s answers and that helps him track the client’s progress. The severity of each symptom is ranked using a scale of one to seven: A score of one means the client does not have the symptom and seven means it’s severe. (Yee., et al 2017). When the PMHNP decide on these ratings, they consider how often the client have this symptom and how much it affects their health and daily life. To complete the BPRS, the interview normally last between 15 to30 minutes.

Reference

American Psychiatric Association. (2020). Practice Guidelines for the Psychiatric Evaluation of Adults, Third Edition. Retrieved from https://psychiatryonline.org/doi/full/10.1176 /appi.books.9780890426760.pe02

Bjorklund, P. (2013). Assessment and diagnosis. In K. Wheeler (Ed.), Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.) (pp. 95-168). Springer Publishing Company.

Gibbs, P. (2020). Psychiatric Interview. Retrieved from /https://physicians.utah.edu/echo/pdfs/psychiatric-interview-module-1.pdf

Sadock, B. J., Sadock, V.A., & Ruiz, P. (2015). Kaplan & Sadock synopsis of psychiatry (11th ed.).

Wolters Kluwer. Yee, A., Ng, B. S., Hashim, H. M. H., Danaee, M., & Loh, H. H. (2017). Cultural adaptation and validity of the Malay version of the brief psychiatric rating scale (BPRS-M) among patients with schizophrenia in a psychiatric clinic. BMC Psychiatry, 17(1), 384. https://doi-org.ezp.waldenulibrary.org/10.1186/s12888-017-1553-2

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