response to colleague discussion

Week 2: Psychiatric Evaluation and Evidence Rating Scale Post: LaShonda Traylor

COLLAPSE

Week 2 Discussion

By

LaShonda Traylor

What are three important components of the psychiatric interview and why you considered these elements? 

1. Psychiatric History
2. Family History
3. Substance Abuse History

Psychiatric History: Specific psychiatric disorders have specific natural histories, with characteristic risk factors, prodromal signs, ages at onset, and prognoses. Obtaining a detailed PPH for a particular person allows you to compare the course of illness with the textbook’s version of the course of illness, increasing the likelihood that you will make a correct diagnosis… Obtaining the psychiatric history will allow the clinician to obtain this from the general treatment history: General questions, current caregivers, hospitalization history, medication history and psychotherapy history (Carlat, 2017).

Family history is an approach to assess if there is a genetic predisposition for a psychiatric disorder by assessing if other family members have or has a certain psychiatric illness.  

Substance Abuse History:  Substance Abuse History isconsidered important because it can assess for a particular behavior that some patient’s may be embarrassed to discuss or to admit. The simple admission of psychiatric symptoms is humiliating for many people, as is the admission of behaviors considered by society to be either undesirable or abnormal. Such behaviors include drug and alcohol abuse, violence, and homosexuality (Carlat, 2017). The patient’s may not be truthful due to embarrassment of being judged for the behavior.

Inventory of Depressive Symptomatology

Explain the psychometric properties of the rating scale. According to the Zhang, Zhao, Zhang, He, et al (2020), the Quick Inventory of Depressive Symptomatology -Self-Rating (-QID-SR) was used to measure the severity depressive symptoms during the past week. The C-QIDS-SR consists of 16 items, in nine domains: (1) sleep; (2) sad mood; (3) appetite/weight change; (4) concentration/decision making; (5) self-outlook; (6) thoughts of death or suicide; (7) involvement (8) energy level; and (9) agitation/retardation. The C-QIDS-SR total score ranges from 0-27, with higher scores indicating more severe depressive symptomatology…The 16 items of the QID-SR were derived from the nine symptoms criteria for major depressive disorder (MDD) in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).

When is it important to use these rating scales with clients during the psychiatric interview?

It would be important to use these scales with adolescents who are not quite able to explain the details of depression symptoms that may be suffering from depression and/or bipolar disorders.

How is the scale helpful to a nurse practitioner’s psychiatric assessment?

This scale would be helpful because it is more detailed than a simple PHQ-9 assessment which does not highlight the important aspects that may impact the treatment plan for a psychiatric patient. The PHQ-9 does not include (i.e., appetite/weight change). These items are often asked or observed in patient’s especially weight loss which may be a result of  a change in or loss of appetite.

References

Carlat, D.J. (2020). The Psychiatric Interview. Fourth Edition. Wolters Kluwer.

Zhang, W.Y, Zhao, Y.J., Zhang, Y., He, F., et al (2020). Psychometric Prospective of the Quick Inventory of Depressive Symptomatology -Self-Report (QIDS-SR) in Depressed Adolescents. Frontier in Psychiatry. Doi: 10.3389/fpsyt.2020.598609.

REPLYQUOTE