2. The Assessment of Mental State, Psychiatric Risk and Co-Morbidity in Eating Disorders

Summary

This chapter provides an overview of the factors involved in assessing psychiatric risk (including a mental state examination (MSE)) and co-morbidity of diagnoses. The following headings/domains can be used as a way of structuring the MSE: appearance, rapport, behaviour, mood (subjective/objective), speech, thought process/content, perceptions, cognition, insight and capacity/judgement. The MSE provides the clinician with a general overview of psychosocial function and can alert them to the possibility of co-morbid mental health possibilities that may predate or run concurrently with an eating disorder (ED). The most common co-morbid mental health problems for eating-disordered clients are depression, anxiety and obsessive compulsive disorder (OCD). In addition to medical risk, the following factors should be assessed as part of a mental health risk assessment: self-harm/suicide, neglect, violence/aggression, physical, social, substance misuse and abuse.