Comprehensive psychiatric assessment

The manuals converge on the need for a structured psychiatric evaluation before psychedelic or related treatment, with attention to diagnosis, baseline severity, and exclusion risks. Across the extracts, this includes confirming depressive disorders, reviewing psychiatric history, and using formal assessment methods such as clinical interviews, mental status examination, and rating scales to determine eligibility and monitor change. They also overlap in highlighting specific symptom domains that can complicate treatment, especially psychosis, bipolarity or mania, suicidality, substance use, and dissociation. Several sources explicitly link assessment to treatment resistance in depression, while others extend the same logic to alcohol use disorder, major psychiatric comorbidity, and post-treatment follow-up. The manuals differ in emphasis. Some are tightly focused on trial entry criteria for major depressive disorder, including structured confirmation of unipolar depression, severity thresholds, and prior treatment adequacy. Others are broader and more exploratory, covering chemically dependent patients, organic brain disease, dementia, personality assessment, or general psychiatric status across admission to discharge. A few sources also differ on how firmly depression functions as an exclusion or contraindication, noting that providers may disagree.