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The setting of the psychiatric assessment is important in that it provides a context that defines the focus of the encounter and therefore the content of the examination. For example, the assessment of the depressed patient in the emergency room is very different from the assessment of the depressed patient in the office, and that is very different from the assessment within a general hospital setting. The assessment of a depressed person in the emergency room focuses on a rapid, yet thoughtful, determination of safety and appropriate disposition—that is, does this person require hospitalization or is treatment in a less restrictive environment more appropriate? To expedite the determination of disposition in the emergency room, the evaluation focuses on issues of safety, suicidal thinking, future orientation, stability of social supports, housing, and recent drug and alcohol use. This assessment should also include a review of recent life events and potential precipitating stressors. Collateral information from family, friends, and outside physicians is helpful in determining the appropriate level of care.

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Table Reference Number
TABLE 53–5. Medications that may cause depression
Table Reference Number
TABLE 53–6. Rating scales for symptoms of depression

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