Clinical Psyciatric Interview Flashcards
What is the psychiatric interview?
- detailed talk with patient
- assessment (asking observing/history)
- having a feel of the patient’s mindset on the day as well to know how to approach them
How to conduct interview
- setting
- safety (sit close to door)
- sensitivity and compassion
- simple language
- curiosity/open/explorative (be interested in what they have to say)
- therapeutic (encourage self help)
- ask what they have been doing to help themselves
- take notes
Format of doing imtervew
-Calgary Cambridge observation guide
What must you remember to do when approaching the patient?
- introduce yourself
- get consent
- open questions (give them time to think)
- clarify points/ask patient to elaborate
- the use closed questions to focus attention on certain areas
- be flexible (even though you ma have structure in our mind)
Briefly, how do you psychiatrically assess someone?
- History
- Mental health examination
- Risk assessment
How to carry out the assessment in detail.
- circumstances of referral
- history of past complaints
- past psychiatric history
- surgical and medical history
- alcohol and drug misuse
- family and personal history (early development/ education/ occupation/ sexual relationships/ pre morbid personality and forensic history)
- current medications
- timescales of complaints
- be non judgemental and understanding
What are usual problems that can be reported?
- unusual/ distressing belief
- abnormal thoughts
- disordered feelings or thoughts
What can be triggers to complaints?
- Alcohol/ drugs
- Psychological interventions
- Medicines
- Social like
- Self care
- neurological or endocrinological factors
- Exacerbating and relieving factors
Personal history points (FAMILY)
- mental illness or physical illness in family
- who they live with
- who is dependent on them
- their support network
Personal history (EVENTS)
-psychological development
-capacity to
form relationships
-their view of themselves and the view around them
Social history points
- Accommodation
- Finances
- Activities
- Occupation
- Social network
- Living situation
What are components of mental state?
Appearance Behaviour Speech Mood Thought Perception Cognition Insight
How do you judge appearance and behaviour of a patient?
- physical characteristics
- eye contact and body language
- are they calm/agitated/moving a lot
- are the open/frightened guarded
- forming a rapport
How to assess speech
- rate of speech
- tone volume
- is it monotonous
- are they not speaking
- is it easy to interrupt them
- hesitation
- spontaneous?
- volume of speech
How to assess mood and affect
- ask patient to describe mood today and past week
- what YOU observe their mood to be
- The Affect is changing of person’s emotion during the interview
How to assess thought
THOUGHT FORM
- flow and logic of thought
- derailing thoughts? Losing focus?
- Too many ideas or thought interference
THOUGHT CONTENT
- delusions
- preoccupations
- overvalued ideas
- suicidal thought
What are delusions?
When a person has an unshakeable belief in something untrue. A common one is that a person may think an organisation or person wants to harm/kill them.
A person with grandiose delusions may believe they have power or authority.
How to chec for suicude and self harm
- ask about thoughts/feelings/urges/images
- suicudal intent/plans/attempts
- signs of self harm
- protective factors
How to chec for suicude and self harm
- ask about thoughts/feelings/urges/images
- suicudal intent/plans/attempts
- signs of self harm (scratches, cuts, pulling out hair, avoiding meals)
- protective factors (any people, religion or pets that stop people harming themselves)
How to check for issues with perception
- Hallucinations (auditory/visual/olfactory/gustatory or tactile)
- Illusions
- Depersonalisation
- Derealisation
How to assess cognition
Assess orientation/ attention/ concentration and memory
If any concerns then carry out tests on:
- language
- calculation
- physiospacial
How to check the patient’s insight
- what they perceive is happening
- what they think is a satisfactory treatment
What are hallucinations?
Sensations that appear to be real but are created within the mind.
