Clinical assessment and investigation in psychiatry

Abstract 

Assessment of patients with mental health problems is often seen as very different from assessment in other areas of medicine. However, such assessments actually share much in common with taking good histories in any area of medicine. They should be conducted in a systematic way using good interview techniques. A clear knowledge of signs of mental illness (such as delusions and hallucinations) is essential for an accurate assessment of a patient’s difficulties. While there are few real diagnostic tests in psychiatry, appropriate investigation of patients includes an assessment of their physical health (and whether this might relate to their psychiatric presentation), formal and detailed assessment of their cognitive function (which can help characterize or localize possible brain pathology) and objective ratings of the severity of symptoms, and neuroimaging.

Keywords: cognitive assessment, neuroimaging, psychiatric history, psychiatric signs, symptom rating scales

• * Thought alienation is typical of schizophrenia and can take the form of thought insertion, thought withdrawal or thought broadcasting. It is psychopathologically related to delusions of physical control; that is, the belief that an external agency is controlling or manipulating the body.