Assessment of the psychiatric patient
This chapter focuses on the clinical skills relevant to the assessment of patients with a mental disorder. Sexual problems can add considerably to the distress of psychiatric disorders, and can be an unexpressed reason for non-compliance with psychotropic medication. Mental ill health may be experienced in women at the time of childbirth, premenstrually and at the menopause. Substances differ in their ability to cause dependence and withdrawal symptoms, and in their tendency to precipitate psychiatric symptoms. Patients may present with symptoms reflecting drug intoxication or withdrawal, or with psychiatric disorders triggered by the abuse of drugs. The mental state examination (MSE) is an assessment of the patient’s behaviour and state of mind at the time of the interview. The MSE may be the only source of information on which to base the initial diagnosis and management, for example in the case of uncooperative or uncommunicative patients.