What is wrong with me? Assessment, diagnosis and the medical model
Rachel Freeth, Brian Thorne, Mike Shooter in Humanising Psychiatry and Mental Health Care, 2017
Assessment is essentially a process of collecting data, interpreting it and then categorising it. The psychiatric interview assessment attempts to collect two types of data. The first is the patient’s ‘history’. This includes such things as basic demographic data, the story of events and details leading up to the current situation, social circumstances and all other relevant factual information, as recounted by the patient, relatives or other significant parties. The second part is the ‘mental state examination’, which is the process of assessing thoughts, mood, perceptions, cognitive functioning and behaviours, and identifying abnormal mental phenomena such as hallucinations or suicidal thinking. In practice, history taking and mental state examination are overlapping processes. Psychiatrists are trained to use a highly structured framework of questions in an attempt to uncover symptoms and symptom clusters, the latter being a pattern of symptoms occurring together, otherwise known as ‘syndromes’. The psychiatric assessment is also not complete without considering physical pathology and performing necessary physical investigations, e.g. physical examination and blood tests.
Psychiatric Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
The diagnostic process in psychiatry generally begins with the psychiatric interview. Similar to any other medical interview or the process of taking a medical history, the objective is to gather the information needed for an accurate diagnosis and the determination of effective treatment. Questioning, however, usually takes an open-ended approach, eliciting from the patient those aspects that seem relevant, since the relationship of ideas and events may have some bearing on diagnosis. Included in the interview is a careful history, but the focus is primarily on the psychiatric difficulty and the symptoms it expresses. Care should be taken to avoid many of the medical terms of psychiatry or to use them in the sense that the patient may (mis)understand, since the terminology is broadly used in society with sometimes very different meanings than in medicine.
Epidemiology of Depression and Anxiety
Siegfried Kasper, Johan A. den Boer, J. M. Ad Sitsen in Handbook of Depression and Anxiety, 2003
In order to obtain reliable diagnoses, interviews are usually based on the standard diagnostic tools, Diagnostic and Statistical Manual for Mental Disorders (DSM) [3] or International Classification of Diseases (ICD-10) [4]. In order to structure the diagnostic process and to obtain objective results, special interview manuals have been developed. These include: The Structured Interview for DSM (SCID), which is a semistructured interview for making the major axis I DSM diagnoses. It is administered by a clinician [5,6].The Mini-International Neuropsychiatric Interview (M.I.N.I.), which is a short, structured diagnostic tool for DSM-IV and ICD-10 psychiatric disorders. With an administration time of approximately 15 min, it was designed to meet the need for a short, but accurate, structured psychiatric interview for multicenter clinical trials and epidemiological studies [7].The Diagnostic Interview Schedule (DIS), which is an interview schedule that allows lay interviewers or clinicians to make psychiatric diagnoses according to DSM criteria [8].The Composite International Diagnostic Interview (CIDI) for DSM [9] or its modified version for ICD-10 [10], which combines questions from the DIS with Present State Examination questions and is fully structured to allow administration by lay interviewers and scoring of diagnoses by computer.
Prevalence, comorbidity, quality of life and use of services of obsessive-compulsive disorder and subthreshold obsessive-compulsive symptoms in the general adult population of Greece
Published in International Journal of Psychiatry in Clinical Practice, 2019
Petros Skapinakis, Spyridon Politis, Andreas Karampas, Petros Petrikis, Venetsanos Mavreas
We assessed psychiatric symptoms and disorders using the computerised version of a structured psychiatric interview, the revised Clinical Interview Schedule (CIS-R) (Lewis, Pelosi, Araya, & Dunn, 1992). This has been used in numerous epidemiological studies in several countries (Araya, Rojas, Fritsch, Acuna, & Lewis, 2001; Botega, Pereira, Bio, Garcia, & Zomignani, 1995; Spiers et al., 2016) including Greece (Skapinakis et al., 2011; 2013). The CIS-R examines the presence, severity and duration of 14 psychiatric symptoms, during the past month. A total score on the CIS-R can be calculated by adding up all symptom sections and this has been used in the past as a general psychiatric morbidity dimension (Singleton, Bumpstead, O'Brien, Lee, & Meltzer, 2001; Skapinakis et al., 2013). In addition, further interview questions allow the application of the ICD-10 research diagnostic criteria (World Health Organization, 1993) to diagnose specific psychiatric disorders using specially derived algorithms (Singleton et al., 2001; Skapinakis et al., 2013). Details on the development of the Greek version of the interview are given elsewhere (Skapinakis et al., 2011; 2013). Reliability was very good with an overall Cronbach’s alpha for the whole CIS-R of 0.86. The test-retest reliability of the CIS-R has been found to be 0.84 (Skapinakis et al., 2011).
Genetic association study of CSNK1E gene in bipolar disorder and circadian characteristics
Published in Nordic Journal of Psychiatry, 2018
Kyu Young Lee, Yong Min Ahn, Se Hyun Kim, Hee-Gyoo Kang, Eun-Jeong Joo
Patients with bipolar disorder were recruited from the psychiatric clinics affiliated with the authors. The diagnosis of bipolar disorder was made according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). After reviewing the available medical records, two psychiatrists reached a consensus diagnosis for each patient. Patients with an organic brain lesion or a physical condition that might cause mood symptoms were excluded from the study. We included patients and controls from our previous studies who had completed the Korean version of the Composite Scale of Morningness (CS). Subjects were college students, nurses, firefighters, and public officers. Each subject completed a brief psychiatric interview performed by a psychiatric research nurse who evaluated current and previous psychiatric conditions. Subjects with a lifetime history of a major psychiatric illness and/or brain trauma were excluded. All patients and control subjects were ethnically Korean. Our final analyses included 215 patients with bipolar disorder (161 with bipolar I disorder and 54 with bipolar II disorder) and 773 controls. All subjects understood the purpose of the study and signed a written informed consent form. The study protocol was approved by the Ethics Committee of Eulji General Hospital and Seoul National University Hospital.
Quality of life, depression, and anxiety in Turkish children with vitiligo and their parents
Published in Psychiatry and Clinical Psychopharmacology, 2019
Özlem Önen, Selcen Kundak, Handan Özek Erkuran, Ayşe Kutlu, Burcu Çakaloz
The Vitiligo Area Severity Index (VASI) scoring system was used to determine the severity of the disorder. Percentage value indicating the affliction of the disorder was evaluated based on employing the hand unit measurement technique. A single hand unit would approximately be equal to 1% of the total body surface area. The degree of pigmentation for each body area is measured by using percentage values. VASI has been identified as the most valid indices in the evaluation of determining the extent and severity of the disorder and safe to be used under any circumstance [52]. Through employing this scoring system, afflicted and non-afflicted zones of all other specific parts of the body (such as hands, feet, breasts, and genital area) could be measured. Information regarding having experienced any stressor event prior to the onset of illness was retrieved from both cases and their parents, through interrogation during the psychiatric interview.
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