Biopsychosocial Model, DSM-5 Diagnostic
Criteria, Suicidal Risk Evaluation, Mental
Status Exam, Sensorium, Affect, Thought
Content and Process, Delusions, Flight of
Ideas, Cognitive Functioning, Insight,
Judgement, Mini-Mental State Examination,
MOCA, Mini-Cog, Psychosis Screening,
Patient Safety, Crisis Intervention, Risk
Management Questions Verified and
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The Biopsychosocial Model
• Used in psychiatry to capture the complexities of patient assessment and needs
• Mirrors our Osteopathic underpinnings of mind, body and spirit
DSM 5
-Summarizes characteristic syndromes of signs and symptoms that point to an underlying
disorder
-contains list of disorders, subtypes, specifiers, and diagnostic codes
-has inclusion and exclusion criteria
-contains ICD 9 and ICD 10 codes
• Have you ever felt that life was not worth living?
• Have you ever felt that you would be better off dead?
• Have things ever gotten to the point where you've thought about harming yourself?
• How likely are you to act on those thoughts in the future?
• What has stopped you from acting on those thoughts?
• Do you feel like you have any reasons to live?
• Are there things that would make you more likely to harm yourself?
What are some questions that you should ask a suicidal patient?
SAFETY
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, What is the number one priority when interviewing a suicidal patient?
1. Be aware of body language such as "clenched fists" and "posturing" as well verbal threats"
2. The prodromal phase lasts 30-60 minutes before erupting into violence
3. Interview in a quiet, non-stimulating environment without a barrier for you to exit
4. Do not stand over the patient
5. Avoid bargaining such as "if you talk to me, I will let you go"
6. Have public safety/security available to intervene if needed
7. Safety is first priority and document situation
What are some ways to promote your safety in a pt that may have aggression or potentially be
violent?
Direct and Simple Questions
In a pt with psychosis, what type of questions should you ask?
Persecutory Delusions
What type of delusions are most common?
Mental Status Exam
• Integral part of a complete physical exam
• Various parts of PE may be expanded or contracted
• Observation and examination of brain functioning
• Meaningful only within the context of the rest of the physical exam
Mental Status Exam
Assesses:
• Appearance
• Behavior
• Speech
• Mood
• Affect
• Thought content
• Thought process
• Perception
• Memory and Cognition
• Insight
• Judgement
Sensorium
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