The psychiatric interview refers to the set of tools that a mental health worker (most times a psychiatrist or a psychologist but at times social workers or nurses) uses to complete a
psychiatric assessment
A psychiatric assessment, or psychological screening, is the process of gathering information about a person within a psychiatric service, with the purpose of making a diagnosis. The assessment is usually the first stage of a treatment process, but ...
.
The goals of the psychiatric interview are:
*Build
rapport
Rapport ( ; ) is a close and harmonious relationship in which the people or groups concerned are "in sync" with each other, understand each other's feelings or ideas, and communicate smoothly.
The word derives from the French language, French ve ...
.
*Collect data about the patient's current difficulties, past
psychiatric history and
medical history
The medical history, case history, or anamnesis (from Greek: ἀνά, ''aná'', "open", and μνήσις, ''mnesis'', "memory") of a patient is a set of information the physicians collect over medical interviews. It involves the patient, and ev ...
, as well as relevant developmental, interpersonal and social history.
*Diagnose the
mental health
Mental health is often mistakenly equated with the absence of mental illness. However, mental health refers to a person's overall emotional, psychological, and social well-being. It influences how individuals think, feel, and behave, and how t ...
issue(s).
*Understand the patient's
personality
Personality is any person's collection of interrelated behavioral, cognitive, and emotional patterns that comprise a person’s unique adjustment to life. These interrelated patterns are relatively stable, but can change over long time per ...
structure, use of
defense mechanisms and
coping strategies
Coping refers to conscious or unconscious strategies used to reduce and manage unpleasant emotions. Coping strategies can be cognitions or behaviors and can be individual or social. To cope is to deal with struggles and difficulties in life. It ...
.
*Improve the patient's
insight
Insight is the understanding of a specific causality, cause and effect within a particular context. The term insight can have several related meanings:
*a piece of information
*the act or result of understanding the inner nature of things or of se ...
.
*Create a foundation for a
therapeutic alliance.
*Foster healing.
The data collected through the psychiatric interview is mostly subjective, based on the patient's report, and many times can not be corroborated by objective measurements. As such, one the interview's goals is to collect data that is both valid and reliable.
refers to how the data compares to an ideal absolute truth that the interviewer needs to access and uncover. Challenges that might affect the interview validity include can be categorized as patient related factors and interviewer related factors. Patient's related factors include:
*Shame: the patient might feel ashamed to discuss some of their difficulties.
*Fear of being judged: while not ashamed the patient might be reluctant to discuss some of the issues that she thinks that she can be judged for.
*Lack of awareness: patient might have distorted recollection of past events with significant emotional valence.
*Cognitive deficits: the patient might have a memory deficit that might impair his ability to correctly recall past events.
*
Secondary gain: the patient decided to misrepresent fact in order to gain a certain benefit (e.g. disability benefits) or avoid a certain penalty (e.g.
insanity defense
The insanity defense, also known as the mental disorder defense, is an affirmative Defense (legal), defense by excuse in a criminal case, arguing that the defendant is not responsible for their actions due to a mental illness, psychiatric disease ...
).
Interviewer related factors include:
*Powerful feelings of like or dislike that might affect the interviewer objectivity.
*Lack of experience: the interviewer lack the skills and knowledge necessary to explore a specific area of pathology.
*
Diagnostic bias: the interviewer is invested in a specific psychiatric diagnosis (e.g. same patient might be diagnosed with schizophrenia by a schizophrenia researcher or bipolar disorder with psychotic features by a bipolar disorder researcher).
refers to how datasets collected by different interviewers or the same interview at different times compare with one another. Ideal reliability is when a dataset will be stable irrespective of changes in specifics of the data collection.
Different interview techniques have been shown to result in variations in the validity and reliability of the collected data. Open-ended question ("Tell me about your sleep.") have been shown to have better validity but less reliability than closed-ended questions("Do you have sleeping difficulties?")
References
{{Psychiatry
Medical diagnosis