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The psychiatric interview is an essential diagnostic tool for psychiatrists, as laboratory tests cannot reveal evidence of psychopathological processes. Three key components of the psychiatric interview include establishing rapport, using open-ended questions and closed-ended questions appropriately, and taking a detailed history of past and present symptoms, including medical, family, social histories and understanding their risk factors. Establishing rapport involves building a trusting, respectful, and empathetic relationship with the patient or caregiver, fostering open communication and mutual understanding. This crucial step helps patients feel understood and respected, encouraging them to share sensitive information. It builds trust, reduces anxiety and resistance, enhances patient satisfaction, and promotes a collaborative approach to treatment (Dreimüller et al., 2019; Psychiatry DataBase, 2024; Forrest, 2020-a).

Using both open-ended and closed-ended questions, are necessary for obtaining specific, concise information and clarifying details. Open-ended questions enhance patient engagement by allowing them to express their thoughts and feelings more fully. These questions help uncover subtle issues that may not be revealed through direct questioning, providing a deeper understanding of the patient’s condition and making the patient feel heard and valued. On the other hand, closed-ended questions help ensure that important facts are not overlooked and provide clear, direct answers that are essential for accurate diagnosis and treatment planning (First, 2022; Psychiatry DataBase, 2024; Forrest, 2020-a). 

Taking a detailed history of past and present symptoms is essential for a comprehensive understanding of the patient’s mental health. These include medical, surgical, psychiatric, family, and social histories, which help identify patterns and potential triggers for symptoms. Additionally, information regarding allergies and medications is equally important. History of presenting illness includes a detailed account of the patient’s current symptoms, covering their onset, duration, intensity, and any factors that exacerbate or alleviate them. A thorough history aids in accurate diagnosis, guides the development of an effective and personalized treatment plan, identifies risk factors, and ensures continuity of care by providing crucial information for future healthcare providers (Forrest, 2020-a; Forrest, 2020-b).

The Brown Attention-Deficit Disorder Scales (BADDS) demonstrate robust psychometric properties, making them highly reliable and valid for assessing ADHD. The Persian version of BADDS showed strong content, concurrent, and construct validity, with test-retest reliability and high internal consistency (Cronbach’s Alpha of 0.979 for the test and 0.888 to 0.942 for subgroups). The original BADDS also exhibits excellent internal consistency (Cronbach’s Alpha of 0.95) and reliable intercorrelation among clusters (0.63 to 0.85). Test-retest reliability is high (r = 0.87), and concurrent validity is strong, with 96% sensitivity and 94% specificity at a cutoff point of 55. The BADDS has been translated into multiple languages, maintaining good internal consistency and fair sensitivity and specificity across versions. Studies indicate that while BADDS has a high sensitivity for diagnosing ADHD, its specificity can be lower in the presence of comorbid conditions like depression. Reliability ranges from 0.685 to 0.809 in various studies. Overall, BADDS is a comprehensive diagnostic tool useful for identifying executive dysfunctions and planning non-pharmacologic interventions and pharmacological interventions, especially in resource-limited settings. It is validated for use across diverse cultural and demographic groups, with scores facilitating age-appropriate comparisons. Its strong psychometric properties make it suitable for both diagnosing ADHD and monitoring treatment responses (Brown et al., 2022; Arshiani et al., 2022; Jackson & Jordan, 2022).

The Brown ADD Scales are appropriate for use when ADD/ADHD is suspected in a client aged 3 years through adult as self-report,  by parents, teachers, and/or clinicians . This can be during initial evaluations for symptoms like inattention, hyperactivity, or impulsivity, or during follow-up visits to monitor treatment progress. They are versatile and suitable for children, adolescents, and adults. For nurse practitioners, the Brown ADD Scales provide a structured and standardized method for assessing ADD/ADHD symptoms. These scales help in several important areas. They systematically identify symptoms, aiding in the diagnostic process and distinguishing ADD/ADHD from similar conditions. By identifying specific areas of impairment, such as working memory or task focus, the scales help develop targeted treatment plans that may include behavioral interventions, educational supports, or medication management. Additionally, the scales are valuable for monitoring treatment effectiveness over time, offering quantifiable measures of symptom changes and enabling necessary adjustments to treatment strategies (Slobodin., & Davidovitch, 2022; Brown et al., 2022).

References

Arshiani, H., Artounian, V., Motamed, M., & Alaghband-Rad, J. (2022). Psychometric Properties of the Persian Version of Brown Attention Deficit Disorder Scale (BADDS). Iran J Psychiatry Behavioral Sciences,16(3), e118912. https://doi.org/10.5812/ijpbs-118912Links to an external site..

Brown, T. E., Chen, J., & Robertson, B. (2022). Improved Executive Function in Adults Diagnosed With Attention-Deficit/ Hyperactivity Disorder as Measured by the Brown Attention-Deficit Disorder Scale Following Treatment With SHP465 Mixed Amphetamine Salts Extended-Release: Post Hoc Analyses From 2 Randomized, Placebo-Controlled Studies. J Atten Disord, 26(2), 256-266. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8678658/Links to an external site.

Dreimüller, N., Schenkel, S., Stoll, M., Koch, C., Lieb, K., & Juenger, J. (2019). Development of a checklist for evaluating psychiatric reports. BMC Medical Education, 19, Article 121. https://doi.org/10.1186/s12909-019-1559-1Links to an external site.

First, M. B. (2022, September). Routine Psychiatric Assessment. Merck Manual. https://www.merckmanuals.com/professional/psychiatric-disorders/approach-to-the-patient-with-mental-symptoms/routine-psychiatric-assessmentLinks to an external site.

Forrest, J. S. (2020-a, September 24). History and Mental Status Examination: overview. Medscape. https://emedicine.medscape.com/article/293402-overview#:~:text=The%20history%20and%20Mental%20Status,to%20make%20an%20accurate%20diagnosisLinks to an external site..

Forrest, J. S. (2020-b, September 24). History and Mental Status Examination: Patient History. Medscape. https://emedicine.medscape.com/article/293402-overview#a2Links to an external site.

Hovde, M. (2022, June 09). Brown Model of ADHD: The Basics. PsychCentral. https://psychcentral.com/adhd/dr-brown-adhd-modelLinks to an external site.

Jackson, R., & Jordan, J. T. (2022). Reliable change in parent-rated scores on the Brown Attention-Deficit Disorder Scales® from pre- to post-participation in the Brain Balance® program. Humanities & Social Sciences Communications, 9, Article 315. https://doi.org/10.1057/s41599-022-01333-yLinks to an external site.

Psychiatry DataBase. (2024, February 01). The Psychiatric Interview. https://www.psychdb.com/teaching/1-psych-interviewLinks to an external site.

Slobodin, O., & Davidovitch, M. (2022). Primary School Children’s Self-Reports of Attention Deficit Hyperactivity Disorder-Related Symptoms and Their Associations With Subjective and Objective Measures of Attention Deficit Hyperactivity Disorder. Front Hum Neurosci, 16, 806047. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8888855/Links to an external site.