Clinical assessment and investigation in psychiatry

Assessment of patients with mental health problems is often seen as different from assessment in other areas of medicine. However, it has much in common with any area of medicine in which taking a good history is vital. It should be conducted in a systematic way using good interview techniques. A clear knowledge and understanding of the signs of mental illness is essential for accurate assessment, which 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 diagnostic tests in psychiatry, the 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 neuro-imaging if indicated.