20 December 2006
Psychiatric rating scales: Helping doctors assess mental health
Many factors, such as overall mood, level of depression, degree of social interaction, and anxiety can be viewed differently by different people, so psychiatrists have developed a variety of ways to rate how a person is feeling more objectively using psychiatric “rating scales”.
What are rating scales?
Rating scales consist of a list of questions or statements that the doctor or patient answers and each response is given a score. The total score is added up and this can be compared to expected answers.
Although there are no “right” or “wrong” answers, people who have a mental illness are more likely to respond in certain ways or display certain patterns of behaviour.
For example, someone who is depressed is likely to report having long-term problems sleeping (insomnia), feelings of worthlessness or listlessness, and perhaps have difficulty concentrating, among many other symptoms1. When a series of questions is asked about these possible symptoms, the combined set of responses can help the doctor to make a diagnosis of depression.
How are they used?
Rating scales can be used to diagnose a mental illness, such as bipolar disorder, schizophrenia, or a major depressive or anxiety disorder, and help doctors and patients decide on the best treatment option.
Doctors may use the same rating scale at each consultation with a patient, so any improvement or deterioration in responses can be seen. When used in this way, rating scales can help the doctor determine how well treatment is working, and if it needs adjusting.
From the doctor’s perspective, the use of one or more rating scales during a consultation can also serve as a “checklist” or reminder to ask certain questions and therefore help him or her interact more effectively with the patient.
Types of rating scales
Commonly used psychiatry rating scales:
How reliable are rating scales? Before they are used in daily clinical practice, rating scales must be thoroughly validated. This confirms that the scores obtained relate to the responses that are given. The rating scales listed in the table above have been in use for many years (since the 1960s in some cases) and doctors and patients can be sure that the results they provide are as accurate as possible. Of course, there will always be some subjectivity in rating a complex symptom such as depression, but when several questions are asked or several scales are used together, then doctors can get a reliable impression of a person’s mental status. References
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