Archive for the ‘Assessment’ Category

Antipsychiatry figures

March 23, 2015

So Long, Beastly F’s (F as in classifying mental illness in ICD e.g. F20)

  • Szasz, Thomas
  • Laing, RD
  • Basaglia, Franco
  • Foucault, Michel

More info here

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Capacity assessment

September 14, 2014

CURB BADLIP

  • Communicate – can the patient communicate their decision?
  • Understand the information given to them?
  • Retain the information
  • Balance – can they balance or weigh-up the information?
  • Best interest – if no capacity, is the decision in their best interest?
  • Advanced Decision already in place which refuses treatment
  • Lasting power of attorney – has one been appointed?
  • Independent mental capacity advocate e.g. emergency
  • Proxy – if unresolved conflict, may require legal input

Source here

Assessing suicidal attempts

September 12, 2014

PPM PAIN HRU

  • Precipitating factors e.g. stress, divorce, death
  • Planning of suicide act
  • Method used e.g. overdose, hanging
  • Precaution against discovery e.g. locked doors, driven far away
  • Alone – were they alone or were people nearby?
  • Intoxication e.g. alcohol or other substances
  • Note – was a suicide note left?
  • Help sought afterwards? Who phoned ambulance – patient/relative/friend?
  • Regret about the act?
  • Understanding – what did he understand by the attempt e.g. did he think 20 tablets would end his life?

Other pointers:

  1. Always ask about symptoms of depression/psychosis
  2. Will they be returning home to the same situation?
  3. What are his thoughts about the future?
  4. Any suicide thoughts still ongoing i.e. are they still actively suicidal after an attempt?

Psychiatric functional enquiry

September 12, 2014

MOAPS

  • Mood – depression, elation
  • Organic – alcohol/drug abuse, physically unwell, dementia
  • Anxiety – worries, obsessions, phobia
  • Psychosis – hallucinations, delusions, thought disorder
  • Suicide/homicidal thoughts

Aetiological sieve

August 27, 2014

VINDICATE

  • Vascular
  • Infection
  • Neoplasm
  • Degenerative
  • Intoxication/drugs
  • Congenital
  • Autoimmune
  • Traumatic
  • Endocrine/metabolic

VITAMINS

  • Vascular
  • Infection/inflammation
  • Trauma
  • Autoimmune
  • Metabolic/malignancy
  • Idiopathic
  • Neurodegenerative
  • Systemic

MMSE

March 23, 2014

OO RAR LV (Ooh, RAR!, love)

  • Orientation to place
  • Orientation to time
  • Registration
  • Attention and concentration
  • Recall
  • Language
  • Visual construction

oorarlv

Factors in determining risk

October 21, 2013

Patients at risk of relapse, pay attention to following to SAVE them and others:

SAVE

  • Stress
  • Alcohol and other substance abuse
  • Violence in past
  • Empathy-lacking

Then go on to do a formal risk assessment.

Abbreviated Mental Test (AMT) questions

September 4, 2013
  • What is your age?
  • What is your date of birth?
  • What year is it?
  • What is this place?

Mental State Examination

September 3, 2013

ASEPTIC

  • Appearance / Behaviour
  • Speech
  • Emotion (mood and affect)
  • Perception (hallucinations, illusions)
  • Though (content, form)
  • Insight
  • Cognition (AMT, MMSE)

Suicide risk assessment

February 13, 2012

SAD PERSONS

  • Sex – male
  • Age – older
  • Depression
  • Previous suicide attempt
  • Ethanol abuse
  • Rational thinking loss e.g. hallucinations, delusions, hopelessness
  • Suicide in family
  • Organised plan
  • No spouse
  • Sickness e.g. chronic disability

One point for each.  Score calculated and suicide risk graded:

  • 0-4 – low risk
  • 5-6 – medium risk
  • 7-10 – high risk