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Kandace H. Main Post     Components and Utility of the Psychiatric Interview and The Brief Psychiatric Rating

Kandace H. Main Post     Components and Utility of the Psychiatric Interview and The Brief Psychiatric Rating

Kandace H.

Main Post

 

 

Components and Utility of the Psychiatric Interview and The Brief Psychiatric Rating Scale  

Introduction 

The process of assessing and treating mental health requires a comprehensive psychiatric interview. During the interview, the patients give their history, a mental status examination, and a risk assessment. These assessments together provide a comprehensive understanding of their condition. The Brief Psychiatric Rating Scale also offers a reliable and valid method of assessing and tracking mental health symptoms. This discussion’s purpose is to identify the importance of these components and discuss the utility of the BPRS in psychiatric practice. 

A psychiatric interview consists of several critical elements, three of which are particularly important: history taking, the mental status examination (MSE), and risk evaluation (Ahmed, 2018, p. 149). The history-taking process involves gathering detailed information on the patient’s psychiatric, medical, social, and family background. Through this process, potential triggers, patterns, and comorbid conditions impacting a patient’s mental health can be identified, thus aiding in the formulation of a differential diagnosis. An MSE measures a patient’s cognitive, emotional, and behavioral functioning (Voss & Das, 2022). Aspects such as appearance, behavior, speech, mood, thoughts, perception, cognition, and insight are included. This assessment is crucial in diagnosing and monitoring mental health conditions as it identifies symptoms such as hallucinations, delusions, mood disturbances, and cognitive impairments. Assessing risk entails determining whether the patient is vulnerable to self-harm, harm to others, or neglect (Oldham, 2020). Among the topics it assesses are suicidal ideation, homicidal thoughts, substance abuse, and the safety of the home. The identification and management of risks are crucial to ensuring the safety of patients and others, for guiding clinical decisions regarding care levels, hospitalizations, and safety plans. 

Brief Psychiatric Rating Scale  

The Brief Psychiatric Rating Scale (BPRS) measures psychiatric symptoms such as depression, anxiety, hallucinations, and unusual behavior (Stojan Bajraktarov et al., 2023). It has three key psychometric properties: reliability, validity, and sensitivity. BPRS has demonstrated good inter-rater reliability, which means that different clinicians tend to obtain similar results, and good test-retest reliability, which indicates consistency over time. Moreover, the scale continues to be valid, correlates well with other established psychiatric scales such as the Positive and Negative Syndrome Scale (PANSS), and has predictive validity (Stojan Bajraktarov et al., 2023). It is also sensitive to changes in symptom severity, so it can be used to track progress over time. As part of initial assessments, the BPRS is typically used to establish a baseline measurement of psychiatric symptoms, to monitor changes in symptom severity throughout treatment, and to assess the effectiveness of interventions, as well as in clinical trials and other studies to quantify symptom changes. 

The BPRS is particularly useful for nurse practitioners since it standardizes assessment, providing a structured approach to assessing psychiatric symptoms and ensuring a comprehensive assessment. Keeping track of progress is essential for evaluating treatment efficacy and making necessary adjustments. It also helps monitor changes in symptoms over time. Moreover, it facilitates clear and consistent communication among healthcare providers about symptom severity, enhancing collaboration. Based on the results of Hofmann et al. (2022) study, the BPRS is reliable and valid across a wide range of populations, including those with schizophrenia and mood disorders. Strong concurrent validity and high inter-rater reliability make the BPRS an excellent tool that aligns well with other established tools, including the Positive and Negative Syndrome Scale. Additionally, changes in scores accurately predict treatment outcomes using the BPRS. A standard training program for clinicians enhances the BPRS’s reliability by ensuring accurate and consistent application. The results of this study affirm the BPRS’s effectiveness in psychiatric assessment and monitoring. The BPRS is widely used in clinical settings for its ability to provide a quick yet comprehensive assessment of psychiatric symptoms. 

Conclusion 

Psychiatric interviews include three essential components: history taking, mental status examination, and risk assessment. The BPRS provides a standardized, reliable, and valid method for measuring and tracking psychiatric symptoms. By using the BPRS, healthcare providers can conduct comprehensive assessments quickly and easily, communicate clearly and consistently, and predict treatment outcomes. The benefit of this is that all members of the treatment team will have a better understanding of the patient’s condition, which will improve collaboration and coordination of care. As a result, the BPRS improves mental health care overall by enabling comprehensive, reliable, and evidence-based assessments, resulting in better patient outcomes. 

 

Ebony G

Main Post

A psychiatric interview starts the relationship between a patient and practitioner. Appropriate questions and observations must occur. Several assessments can aid the practitioner in understanding the patient’s needs better. A brief overview of essential parts of the psychiatric interview is discussed in the following. The assessment to be reviewed is the Overt Aggression Scale. Both can save lives and improve patient outcomes.

Psychiatric Interview

The psychiatric interview of an adult consists of assessing the patient (aggression and psychiatric behavior), medical history, psychiatric history, substance abuse assessment, culture assessment, suicidal risk assessment, review of traumatic events, and decision-making process (American Psychiatric Association, 2016). The three components of the psychiatric interview that I find essential are the medical history, psychiatric history, and mental status examination/assessment of the patient (First, 2022). When assessing a patient, you must build a foundation to know where to begin. Understanding health problems or past mental issues gives one insight into the patient’s needs. It may also explain the patient’s examination. Health problems can trigger mental health issues. There is a correlation between depression and chronic health conditions (Herrera et al., 2021). Psychiatric issues may progress, or coping mechanisms are taught but rarely disappear entirely. Also, as we go on in life, more trauma or life-changing moments occur that can affect mental health. A thorough patient assessment may give abundant information on their current stability. The patient may express depressive behavior, track marks may be visible from drug use, or a hyper state may bring insight into medication compliance, dangers, and more.

Overt Aggression Scale

The Overt Aggression Scale was the first official scale used to assess aggression in a patient. The assessment used a 0-5 scale grading verbal assault, violence with objects, self-injury, and violence against others to understand the severity of aggression a patient has (Coccaro, 2020). Unfortunately, aggression comes with multiple mental health issues and can lead to severe injuries. Even children and adults without a psychiatric diagnosis can benefit from being assessed for aggression to improve their needs, keep all persons safe, provide appropriate medications, and, if found and treated, improve socialization (Blader, 2024). The Overt Aggression Scale has been modified since its introduction but proves to be needed in initial assessments and follow-up visits, especially with changes in behavior. Once trained to conduct the Overt Aggression Scale, practitioner scores rarely vary. Less variability makes it a reliable assessment in gauging aggressive behavior.

Patient assessments are essential. As a practitioner, you see aggressive behavior in all age groups. Children can struggle with expressing themselves and lash out. Adults who may have undergone trauma or health issues or have poor impulse control may use aggression. Cognitive decline in the advanced age groups can also cause aggressive symptoms (Ravwyts et al., 2021). A practitioner must understand behaviors’ manifestations and their severity to protect all. Performing the Overt Aggression Scale allows for insight and improvement. Ethically, we owe our patients the best opportunity to live a life of excellent quality. 

 

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