Clinical assessment and investigation in psychiatry

Assessment of patients with mental health problems is often seen as very different from assessment in other areas of medicine. However, such assessments actually have much in common with any area of medicine in which taking a good history is vital. They should be conducted in a systematic way using good interview techniques. A clear knowledge of signs of mental illness (such as delusions and hallucinations) is essential for an accurate assessment of a patient's difficulties. This should allow the clinician to reach a differential diagnosis, and to estimate how much confidence can be placed in the primary diagnosis. Although there are few real diagnostic tests in psychiatry, appropriate investigation of patients includes an assessment of their physical health (and whether this might relate to their psychiatric presentation), formal and detailed assessment of their cognitive function (which can help characterize or localize possible brain pathology), objective ratings of the severity of symptoms, and neuroimaging.