Scribd
Upload
532 views3 pages

The Psychiatric History

The document outlines the components of a psychiatric history and mental state examination. The psychiatric history section includes identifying information, history of presenting complaints, psychiatric review of systems, medical history, and personal, family, and social histories. The mental state examination section examines general appearance, speech, affect, thought, perception, cognition, judgement, insight, and rapport.

Uploaded by

emmaaziz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
532 views3 pages

The Psychiatric History

The document outlines the components of a psychiatric history and mental state examination. The psychiatric history section includes identifying information, history of presenting complaints, psychiatric review of systems, medical history, and personal, family, and social histories. The mental state examination section examines general appearance, speech, affect, thought, perception, cognition, judgement, insight, and rapport.

Uploaded by

emmaaziz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 3

The Psychiatric History:

1. Identifying information:
- Socio-demographic summary
- Name
- Age
- Marital status
- Living arrangements
- Occupation or how do they support themself?
- Voluntary or involuntary patient
2. History of Presenting Complaint:
- Symptoms
- Onset
- Duration/course
- Precipitants
- Exaggerating/alleviating factors
- Impact of illness of patients social, occupational, financial functioning
- Note current and previous treatment (dose and duration)
3. Psychiatric review of systems:
- Depression:
o Mood
o Energy or psychomotor disturbance
o Interest or enjoyment
o Motivation
o Appetite/weight change
o Sleep disturbance
o Hopeless/helpless themes and guilt
o Indecisiveness or poor concentration
o Suicidal ideation
- Mania: (now or in the past)
o Particularly happy or elevated
o Decreased need for sleep
o Grandiosity
o Pressured speech, flight of ideas or racing thoughts
o Distractibility
o Increase in goal-directed activity or psychomotor agitation
o Excessive involvement in pleasurable activity with high potential
for painful consequences
- Psychosis:
o Ideas of reference: t.v. or radio talking specifically about you?
o Hallucinations: hear voices when no-one is around?
o Paranoia:
Feel like people are taking particular notice of you?
Feel that someone might want to hurt you?
Difficulty concentrating
o Negative symptoms: lack of motivation, low mood etc
- Anxiety:
o Feel worried or nervous about everyday things or going out in
public places?
o Heart racing, shortness of breath, sweaty etc
o Particularly concerned about a particular thing or things (OCD)
4. Medical History

- Current and past medical conditions


- Current and past treatment
5. Personal history of psychiatric disorders and treatment:
- Details of previous episodes of illness
- Previous psychiatric admissions/treatment
- Outpatient/community treatment
- Suicide attempts/drug and alcohol abuse
- Interval function (what is the patient like between episodes when
well)
6. Family history of psychiatric disorders and treatment
7. Personal history:
- Prenatal/birth history
- Childhood
- Adolescence
- Adulthood:
o Educational
o Occupational
o Interpersonal/social
o Sexual
o Drug and alcohol use
o Marital history
o Children
o Leisure
o Forensic history

The Mental State Examination:


1. General appearance and behaviour:
2. Speech:
3. Affect and mood:
a. Quality
b. Range
c. Appropriateness
d. Assessment of suicidality
4. Thought:
a. Stream
b. Form
c. Content (obsessions/delusions)
5. Perception
a. Hallucinations/illusions
b. Depersonalisation
c. Derealisation
6. Cognition
a. Level of consciousness
b. Orientation
c. Concentration
d. Memory
e. Intelligence
Note: can just say not formerly assessed
7. Judgement
8. Insight
9. Rapport

OSCE Stations:
1.

You are a registrar working at a general psychiatric ward assessing a new


patient in the clinic. He is a 21 year old man who has a 2 month history of
social withdrawal, problems with sleep and concentration and a decline in
his academic functioning. There is also a history of personal decline. You
have taken a history and have reached the point in the mental state
examination where you need to elicit perceptual abnormalities.

2. Mr Da Silva, a 19 year old man with a 3 month history of social withdrawal


has been referred to you by his GP. His parents have noticed that there
has been a gradual decline in him socialising and he is more or less
confined to his room. They have noticed that he is paranoid at times.
You have taken a brief history and have reached the stage in the mental
state examination where you need to elicit any abnormalities in his
thinking.

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy