Psychiatry Patient Presentation?

[nevadabear123]

Hello everyone,

I've been asked by some of the MS3's how to do patient presentations in psychiatry, and to be frank, I kind of learned it on the go? I didn't really have any resources that I used. However, are there any resources that you all know of that I can pass on to some of these MS3's about to start their psychiatry clerkship? I know there are tons of medicine presentation formats online but not sure about psychiatry?

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[NickNaylor]

Depends on how interested they are. They're really not that different than a typical patient presentation other than the fact that some of the content is different. Some discussion about a biopsychosocial formulation might be helpful, and if they're interested they might take a look at The Perspectives of Psychiatry that gets this point across.

 

[FlowRate]

It's almost exactly the same thing as any other patient population except you're more likely to include substance and social history and your mental status exam takes the place of the physical exam. You're otherwise still reporting one-liner, HPI/ROS, past history, exam, data (if relevant), assessment, and plan.

 

[Crayola227]

IIRC A/P had a somewhat unique aspect compared to your typical problems list? Like going by each Axis or something

Unless they did away with that after DSM IV

 

[calvnandhobbs68]

IIRC A/P had a somewhat unique aspect compared to your typical problems list? Like going by each Axis or something

Unless they did away with that after DSM IV

Was a thing but nobody does individual Axis listing anymore with DSM V and nobody really does GAF scoring anymore either...probably because it wasn't that helpful.

 

[WisNeuro]

Was a thing but nobody does individual Axis listing anymore with DSM V and nobody really does GAF scoring anymore either...probably because it wasn't that helpful.

The GAF was just throwing a dart at a dartboard for many providers. Recently reviewed an old outpatient psych eval for a re-evaluation of cognition where the provider gave the patient a GAF of 40, despite the fact that they were working full-time and fully independent in I/ADLs. Most people using the GAF score had no good idea of what the anchor points looked like. Good riddance to a **** measure, I say.

 

[Monocles]

The GAF was just throwing a dart at a dartboard for many providers. Recently reviewed an old outpatient psych eval for a re-evaluation of cognition where the provider gave the patient a GAF of 40, despite the fact that they were working full-time and fully independent in I/ADLs. Most people using the GAF score had no good idea of what the anchor points looked like. Good riddance to a **** measure, I say.

A particular notorious attending at my medical school used to play "guess the GAF" game using photos of the overnight admits. He begrudgingly stopped when med students reported him.

 

[tr]

Really? I liked the GAF, I was sad they got rid of it. I started putting it back in my notes because I find it helpful to have a record of some quantified value for overall function over time. Wikipedia helpfully lists the anchor points anytime a reminder is needed.

 

[NickNaylor]

Really? I liked the GAF, I was sad they got rid of it. I started putting it back in my notes because I find it helpful to have a record of some quantified value for overall function over time. Wikipedia helpfully lists the anchor points anytime a reminder is needed.

For the fastest possible "gestalt" impression I agree, it was somewhat helpful. Obviously fairly subjective, but nevertheless somewhat informative.

 

[ridethecliche]

Do y'all have consult psych templates you give residents or students? I found these really helpful for helping me organize my thoughts before, during, and after I see a patient. I still look at them sometimes when doing presentations to keep myself on task.

 

[nevadabear123]

Do y'all have consult psych templates you give residents or students? I found these really helpful for helping me organize my thoughts before, during, and after I see a patient. I still look at them sometimes when doing presentations to keep myself on task.

Do you know where I could find these templates? Or can you PM me them? Thank you! I'm looking to help the MS3's.

 

[ridethecliche]

Do you know where I could find these templates? Or can you PM me them? Thank you! I'm looking to help the MS3's.

Send me a message and remind me. I'll send you something!