Over the past few months, I’ve been doing more and more rating scales with patients. When people first come in, they download and fill out an initial form which asks the usual demographic information like addresses and phone numbers but also includes a patient health questionnaire (PHQ) . The PHQ screens for somatization disorder, panic disorder, anxiety disorder, eating disorder, and alcohol problems. The PHQ is the only self-report rating scale I use; I think the clinician-administered rating scales are better.
When I see someone the first time I usually do:
- the Short Portable Mental State Questionaire (SPMSQ),
- the Hamilton depression scale (HAMD), and
- the Brief Psychiatric Rating Scale (BPRS).
Depending on what else is going on, I sometimes do:
- the Mini-Mental State Exam (MMSE),
- the Hamilton Anxiety scale (HAMA),
- the Young Mania Scale (YMRS),
- the Adult ADHD Self-Report scale (ASRS) , or
- the Yale-Brown Obsessive Compulsive Scale (YBOCS).
For follow up visits, I sometimes do:
- the HAMD
- the HAMA, or
- the YMS,
depending on how the patient is doing.
Really, there aren’t that many things that you can’t do by telepsychiatry, but there are some. For example, it’s impossible to do parts of the AIMS without touching the patient, and the HAMD asks me to look for things like fidgetiness, which might be hard to see on a skype call.
I can see a PhD thesis in here somewhere called “Adapting Psychiatric Rating Scales for Telepsychiatry.”
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