NRNP PRAC 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales Essay

NRNP PRAC 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales Essay

NRNP PRAC 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales Essay

The psychiatric interview is critical for diagnosing and treating patients who are suffering from mental illness. The purpose of the psychiatric interview is to establish a therapeutic relationship with the patient in order to collect, organize, and synthesize data that can be used to formulate, differential diagnose, and treat the patient.

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The most critical component of a psychiatric interview is the history of the current illness. It entails an exhaustive examination of the patient’s primary complaint and concerns (Sadock et al., 2015). Additionally, the information gathered during this portion of the interview will be critical in diagnosing the patient and developing a treatment plan for him or her (Carlat, 2017).

Another critical component of the psychiatric interview is the history of mental illness and treatment. To comprehend a patient’s current mental illness, we must first learn about and comprehend the patient’s prior battles with mental illness and treatment (Sadock et al., 2017). Understanding the patient’s prior psychiatric illness and treatment will assist in comprehending the patient’s current illness, including previous treatments that worked.

The patient’s medical history is another critical component of the psychiatric interview (Sadock et al., 2017). It is necessary to ascertain whether the patient has any medical history that could jeopardize the proposed treatment regimen. As an illustration, consider a patient who is suffering from end-stage renal failure and/or liver disease. In that case, we will either have to change the prescribed medication or reduce the prescribed dose, as the patient’s body will not metabolize the drug normally. This is analogous to determining whether the patient has a history of seizures, as certain medications may lower the seizure threshold.

Various valid and reliable measurement tools can be used during the psychiatric interview to assist in diagnosing various mental illnesses and evaluating current treatment. The following section will discuss the Brief Psychiatric Rating Scale (BPRS). To summarize, the BPRS is an 18-item rating scale that clinicians and researchers use to assess psychiatric symptoms such as depression, anxiety, and hallucinations, as well as schizophrenia. The BPRS contains a variety of subscales that may be used for a variety of purposes. For instance, the BPRS-5 subscale is a sensitive screening tool that may aid in the identification of psychotic depression (Park et al., 2017). The BPRS-6 includes categories for categorizing and staging three positive symptoms, including delusions, conceptual disorganization, and hallucinations, as well as three negative symptoms, including blunted affect, emotional withdrawal, and poor speech (Bech et al., 2018). The diagnostic test specifically examines somatic symptoms, anxiety, emotional withdrawal, conceptual disorganization, guilt feelings, tension, mannerisms and posturing, grandiosity, depressive mood, hostility, suspiciousness, hallucinatory behavior, motor retardation, uncooperativeness, unusual thought content, blunted affect, excitement, and disorientation. This rating scale would be beneficial in determining the severity of schizophrenia by assessing positive and negative symptoms, affect, and activation (Shafer et al., 2017). As a psychiatric mental health nurse practitioner, it would be beneficial to apply these rating scales because they would alter the course of therapy and medication. While the instrument is beneficial, the clinician is ultimately responsible for determining its effectiveness. Although the instrument has a high level of internal reliability, its suitability for patients with special needs, such as geriatric patients, remains debatable. The best way to address such issues, especially if the patient is unable to do so appropriately, is to involve the patient’s family members. When families are actively involved in their care, information and application are more effective.

References

Bech, P., Austin, S. F., Timmerby, N., Ban, T. A., & Møller, S. B. (2018). A clinimetric analysis of a BPRS-6 scale for schizophrenia severity. Acta Neuropsychiatrica, 30(4), 187–191. https://doi.org/10.1017/neu.2017.40

Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer.

Park, S.-C., Østergaard, S. D., Choi, J., Kim, J.-M., Jun, T.-Y., Lee, M.-S., Kim, J.-B., Yim, H.-W., & Park, Y. C. (2015). Is the BPRS-5 subscale of the psychotic depression assessment scale a reliable screening tool for psychotic depression? Journal of Affective Disorders, 174, 188–191. https://doi.org/10.1016/j.jad.2014.11.014

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2017). Psychiatric interview, history, and mental status examination. In Kaplan and Sadock’s Concise Textbook of Clinical Psychiatry (4th ed., pp. 9–15). Wolters Kluwer.

Shafer, A., Dazzi, F., & Ventura, J. (2017). Factor structure of the Brief Psychiatric Rating Scale – expanded (BPRS-E) in a large hospitalized sample. Journal of Psychiatric Research, 93, 79–86. https://doi.org/10.1016/j.jpsychires.2017.05.011

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To Prepare:
Review this week\’s Learning Resources and reflect on the insights they provide regarding psychiatric assessment and diagnosis.
Consider the elements of the psychiatric interview, history, and examination.
Consider the assessment tool assigned to you by the Course Instructor.

Post a brief explanation of three important components of the psychiatric interview and why you consider these elements important. Explain the psychometric properties of the rating scale you were assigned. Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.