Behavioral Health in Primary Care



Behavioral Health in Primary Care






PRIMARY CARE ASSESSMENT















































AMPS SCREENING


Anxiety Mood Psychosis Substance


This approach is easily used in the primary care setting as a starting point to develop a reasonable differential diagnosis


SYMPTOM


SCREENING QUESTIONS


SCALE


Anxiety


Is anxiety or nervousness a problem for you?


GAD-7


Mood


Depression: Over the last few weeks, have you been feeling depressed, sad, or hopeless? Have you engaged in pleasurable activities?


PHQ-9


Bipolar: Have you ever felt the complete opposite of depressed where family and friends were worried about you because you were too happy or unreasonably irritable? Have you ever had excessive amounts of energy running through your body, to the point where you did not need to sleep for days?


MDQ


Psychosis


Do you see or hear things that other people do not? Do you have thoughts that people are trying to follow, hurt, or spy on you?



Substance


How much alcohol do you drink in a day?


AUDIT-C


Have you been using any cocaine, methamphetamines, heroin, marijuana, PCP, LSD, ecstasy, or other drugs?


DAST


MENTAL STATUS EXAM


The MSE is the mental health equivalent of a physical exam, should be observed in all patients, and documented when abnormal


Appearance


Speech


Mood


Affect


Thought process


Thought content


Perceptions


Cognition


Insight


Judgment


Grooming, dress, and behavior


Rate, rhythm, volume, and intensity


A direct quote from the patient (eg, “terrible”)


Observed emotions and variation during interview


How the patient is thinking (eg, how well connected is one thought to the next)


What the patient is thinking (eg, obsessions, delusions, or suicidal/homicidal ideation)


Presence of illusions or hallucinations


Attention, awareness, cognition, and memory


Understanding of symptoms and circumstances


Ability to make reasonable decisions

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May 8, 2019 | Posted by in PSYCHOLOGY | Comments Off on Behavioral Health in Primary Care
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