Evaluation and Diagnostic Methods in Mental Health

EVALUATION
AND DIAGNOSIS
METHODS IN
MENTAL
HEALTH
STUDENT: ALONDRA GUADALUPE GUTIERREZ VENTURA

CLASSROOM: 9
GROUP A
GENERAL NURSING TECHNICIAN
GRADE: 6” QUARTER
Mental status assessment
The mental status examination includes: observation of the patient, interview
with the patient, interview with family members or people around them, as
well as the results of complementary examinations. Require evaluation:
1) threat of suicide, as well as aggressive behavior against oneself or the

environment
2) presence of psychopathological symptoms and syndromes
3) association of psychiatric disorders with somatic disorders, with side

effects of medications or with intoxications and withdrawal syndromes.
Simultaneously, it is necessary to adopt supportive therapeutic

interventions, as well as guarantee the safety of the patient and other related
people, including the application of direct coercive measures.
The objective of the basic mental status examination is to establish why a

certain patient (previous psychiatric disorders, personality, existential
situation) with certain symptoms (main complaints expressed by the patient
and confirmed by the doctor) consults at a certain time (releasing factors:
psychological, social, interpersonal, existential, somatic, psychoactive
substances, etc.).
Basic Mental Status Assessment
The examination of the patient with acute symptoms of psychiatric problems

should begin with the evaluation of the state of consciousness, because
their disorders (quantitative and qualitative) frequently have a somatic cause
(infections, disorders of acid-base balance or electrolytes, poisonings,
withdrawal syndromes). The evaluation considers the following questions
1. Consciousness state:
1) quantitative disorders: impaired reaction to stimuli (quantitative disorders

of consciousness →
2) qualitative disorders: altered orientation (if the patient does not know who
he is or where he is and if he is well oriented in time).
2. General appearance and behavior: evaluation of psychomotor impulse and

will functioning: agitation, stupor, stereotypies (almost identical repetition of
behavioral patterns), compulsive acts, impulsive acts.
3. Attitude towards one's own mental state: awareness of illness, criticism,

willingness to collaborate with the doctor.
4. Emotional state. Assessment:
1) anxiety, fear, restlessness, tension
2) mood: decrease (from normal sadness to subclinical depression or

depression), elevation (from normal joy to sustained euphoria, hypomania
and mania), mixed states (simultaneously depressive and manic symptoms),
anger, anger, indifference
3) adaptation of emotions to situations.
5. Thought:
1) formal disorders of thought: acceleration or slowing down of its speed

(exaggerated thoroughness), blocking (sudden obstruction of the flow of
thoughts), splitting → later, perseveration (stereotyped repetitions), flight of
ideas, increase in the content of ideas, disintegrated or incoherent thinking,
neologisms (construction of new words), ruminations (repeated thoughts)
2) disorders of thought content: delusional ideas, delusions →later.
6. Perception: hallucinations (perception of non-existent stimuli), illusions

(deformed perceptions of existing stimuli).
7. Higher cognitive functions: memory, ability to concentrate attention, ability
to adequately evaluate reality, to develop abstract thinking and self-
reflection, as well as ability to control one's own impulses (aggressive,
sexual).
8. Presence or absence of psychotic phenomena: the mental status

examination must conclude. Some important information obtained from
people with these disorders may be distorted due to the presence of
disorders in the perception of reality and the perception of one's own
identity, which is why interviewing people close to the patient may be useful.
In cases of restlessness and aggressiveness, management is different from
that recommended in people without psychotic disorders.
The most important psychotic symptoms are:
1) hallucinations: deep convictions about perceived objects, which do not

exist in reality
2) delusional ideas and delusions (thought disorders): false judgments of
pathological origin that are accompanied by a priori evidence (certainty
independent of experience) and to which the patient adheres with a
subjective certainty, despite the fact that it is in opposition to the reality, with
the experience of the rest of human beings and with collective opinions and
beliefs. These ideas can be congruent with the patient's affects, finding
expression in accordance with the aspirations and behaviors of the person
who suffers from them. In most cases, correction through new experiences
and explanations is not possible, as long as the state from which they
originated persists. Delusions and delusional ideas can be differentiated
according to their content: persecutory, jealousy, hypochondriacal, sin and
guilt, humiliation, incapacity, impoverishment or nihilistic, grandiosity,
reference, influence or control.
3) delusional attitude: disposition favorable to delusional thinking
4) delusional interpretation of reality: delusional explanation of certain real

events
5) disintegration or loss of associations: absence of the logical relationship

between particular fragments of thought, expression or between sentences
6) catatonic symptoms:
a) hypokinetic - motility disorders in the form of inhibition of movements or

their motionless "freezing"
b) hyperkinetic: increased motility or disorganized motor agitation
A health evaluation A mental health evaluation is an examination of the

health of your mind. Lets you find out if you have a mental illness . Mental
illnesses are common, affecting more than half of people at some point in
their lives. There are many types of mental illnesses. Some of the most
common are:
 Depression and mood disorders: These mental illnesses are different from
sadness or grief. They can cause extreme sadness, anger, or frustration
 Anxiety disorders : Anxiety can cause excessive worry or fear in real or
imagined situations
 Eating disorders : These disorders generate obsessive behaviors and
thoughts related to food and body image. They can cause a person to
dangerously limit the amount of food they eat, eat uncontrollably, or a
combination of both.
 Attention deficit hyperactivity disorder (ADHD) : ADHD is one of the most
common mental illnesses in children. It can continue into adulthood. People
with ADHD have difficulty paying attention and controlling impulsive
behavior.
 Post-traumatic stress disorder (PTSD) : This disorder can occur after a
traumatic experience, such as war or a serious accident. People with PTSD
feel stressed and afraid, even long after the danger has passed.
 Alcohol or drug abuse and addictive disorders: These disorders involve
using alcohol or drugs excessively. Affected people are at risk of overdose
and death
 Bipolar disorder : Formerly known as manic depression. People with bipolar
disorder have alternating episodes of mania (extreme euphoria) and
depression
 Schizophrenia and psychotic disorders : These are some of the most serious
psychiatric illnesses. They can cause a person to see, hear, or believe things
that are not real
Mental health is an examination of the health of your mind. Lets you find out
if you have a mental illness . Mental illnesses are common. In the United
States, they affect more than half of people at some point in their lives. There
are many types of mental illnesses. Some of the most common are:
 Depression and mood disorders: These mental illnesses are different from
sadness or grief. They can cause extreme sadness, anger, or frustration
 Anxiety disorders : Anxiety can cause excessive worry or fear in real or
imagined situations
 Eating disorders : These disorders generate obsessive behaviors and
thoughts related to food and body image. They can cause a person to
dangerously limit the amount of food they eat, eat uncontrollably, or a
combination of both.
 Attention deficit hyperactivity disorder (ADHD) : ADHD is one of the most
common mental illnesses in children. It can continue into adulthood. People
with ADHD have difficulty paying attention and controlling impulsive
behavior.
 Post-traumatic stress disorder (PTSD) : This disorder can occur after a
traumatic experience, such as war or a serious accident. People with PTSD
feel stressed and afraid, even long after the danger has passed.
 Alcohol or drug abuse and addictive disorders: These disorders involve
using alcohol or drugs excessively. Affected people are at risk of overdose
and death
 Bipolar disorder : Formerly known as manic depression. People with bipolar
disorder have alternating episodes of mania (extreme euphoria) and
depression
 Schizophrenia and psychotic disorders : These are some of the most serious
psychiatric illnesses. They can cause a person to see, hear, or believe things
that are not real
INTERVIEW TECHNIQUE
1. Reassure the patient during initial contact, observe his

behavior.
2. Explore your emotions and respond empathically.
3. Analyze the patient's level of understanding and awareness of
the disorder.
4. Become an expert: ask appropriate questions and provide
contextualized information about the problem.
5. Establish authority: explain responsibility and medical
commitment to the patient.
6. Adaptation of the interviewer's role to the situation: a)
empathetic listening; b) expert attitude; c) show of authority.
7. Analyze the role of the patient:
a) those who expect expert and adequate care for their illness;
b) the “sufferer” who expects inadequate emotional involvement;
c) the one who expects privileged attention at all times. Adapt the
limits of the interview to this role
BASIC ELEMENTS OF THE CLINICAL HISTORY
1. Basic identifying and sociodemographic data. Genogram.

Relevant social relationships. Socio-family support.
2. Main reason for consultation.
3. History of the current disorder, arranged chronologically.
Precipitating and associated factors of the problem. Impact on
family, social and work areas.
4. Psychiatric and medical-surgical history. Previous treatments,
hospitalizations, suicide attempts.
5. Biographical data explored according to the patient's age.
6. Psychopathological examination: the patient's mental state.
MENTAL EXAM
1. Appearance and psychomotor behavior.
2. Level of consciousness and temporal-spatial orientation.
Attentional capacity.
3. Higher cognitive functions: memory, abstraction, calculation,
judgment capacity. Intelligence. 4. Emotions: affection, mood,
anxiety.
5. Language. Form and content of thought.
6. Perception.
7. Disorder awareness
CLASSIFICATION AND
DIAGNOSIS MANUALS: DSM V
AND ICD 10
Disorders of onset in infancy, childhood or adolescence

[
The manual groups in this section the disorders that arise at this age
(although they are not necessarily diagnosed during childhood or
adolescence).
 Intellectual disability : an intellectual ability significantly below average

(measured through IQ ); It can be mild, moderate, severe or profound.
 Learning disorders : academic performance considerably below what is
expected in the affected area, considering the age of the child or
adolescent, his or her intelligence, and age-appropriate education. They
may be:
o Reading disorder: dyslexia
o Calculation disorder: dyscalculia
o Written expression disorder: dysgraphia
o Unspecified learning disorder
 Motor skills disorder
o Developmental coordination disorder
 Communication disorders . This section considers speech or language
deficiencies:
o Expressive language disorder
o Mixed receptive-expressive language disorder
o Phonological disorder
o Stammering
o Unspecified communication disorder
 Pervasive developmental disorders : These are serious deficits and
alterations in various areas of development, such as social interaction,
communication, or the existence of stereotyped behaviors, interests or
aptitudes. Are included:
o autistic disorder
o Rett disorder
o Childhood disintegrative disorder
o Asperger's disorder
o Pervasive developmental disorder not otherwise specified
 Attention deficit disorders : include disorders whose characteristics are
maladaptive impulsivity-hyperactivity or disruptive behavior disorders
(violation of the rights of others, hostility, defiant behavior). Are included:
o Attention deficit disorder with or without hyperactivity
o conduct disorder
o Oppositional defiant disorder
o Unspecified disruptive behavior disorder
 Ingestion and eating behavior disorders of infancy or childhood: these
consist of various alterations that occur persistently in the eating
behavior of children and adolescents. These constitute:
o Pica disorder
o Rumination disorder
o Eating disorder of infancy or childhood
 Tic disorders
o La Tourette's disorder
o Chronic motor or vocal tic disorder
o Transient tic disorder
o Unspecified tic disorder
 Elimination disorders: disorders whose characteristic is the elimination
of feces and urine in inappropriate places and in a persistent manner.
Are:
o Encopresis
o Enuresis (not due to a medical illness)
 Other disorders of infancy, childhood or adolescence:
o Separation anxiety disorder : defined as excessive anxiety for age
regarding separation from home or loved ones.
o Selective mutism : when the child or adolescent does not speak in
specific situations, such as social situations, but in others they do not
have language problems.
o Reactive attachment disorder of infancy or childhood: Given by a
manifestly altered social relationship, generally caused by pathogenic
parenting.
o Stereotyped movement disorder: apparently impulsive, stereotyped
and non-functional repetitive movement disorder that causes
discomfort in the subject.
o Unspecified disorder of infancy, childhood or adolescence

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EVALUATION

STUDENT: ALONDRA GUADALUPE GUTIERREZ VENTURA

1) threat of suicide, as well as aggressive behavior against oneself or the

2) presence of psychopathological symptoms and syndromes

3) association of psychiatric disorders with somatic disorders, with side

Simultaneously, it is necessary to adopt supportive therapeutic

The objective of the basic mental status examination is to establish why a

The examination of the patient with acute symptoms of psychiatric problems

1) quantitative disorders: impaired reaction to stimuli (quantitative disorders

2. General appearance and behavior: evaluation of psychomotor impulse and

3. Attitude towards one's own mental state: awareness of illness, criticism,

4. Emotional state. Assessment:

1) anxiety, fear, restlessness, tension

2) mood: decrease (from normal sadness to subclinical depression or

3) adaptation of emotions to situations.

1) formal disorders of thought: acceleration or slowing down of its speed

2) disorders of thought content: delusional ideas, delusions →later.

6. Perception: hallucinations (perception of non-existent stimuli), illusions

8. Presence or absence of psychotic phenomena: the mental status

The most important psychotic symptoms are:

1) hallucinations: deep convictions about perceived objects, which do not

3) delusional attitude: disposition favorable to delusional thinking

4) delusional interpretation of reality: delusional explanation of certain real

5) disintegration or loss of associations: absence of the logical relationship

a) hypokinetic - motility disorders in the form of inhibition of movements or

b) hyperkinetic: increased motility or disorganized motor agitation

A health evaluation A mental health evaluation is an examination of the

1. Reassure the patient during initial contact, observe his

BASIC ELEMENTS OF THE CLINICAL HISTORY

1. Basic identifying and sociodemographic data. Genogram.

Disorders of onset in infancy, childhood or adolescence

 Intellectual disability : an intellectual ability significantly below average

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