History

Question 1

Sections of a psych history

Answer 1

PC

HPC

Psych hx

Med hx

DH

FH

Personal Hx

SHx

Substance abuse

Forensic Hx

Pre-morbid personality

Question 2

What is an alternative approach?

Answer 2

Start with demographics, presenting complaint then all the rest of the history before you do HPC

Question 3

Two important things to ask in HPC

Answer 3

Risk assessment of harm to self and others

How it is affecting their life

Question 4

What do you ask in psych history?

Answer 4

Seen psychiatrist before

Admitted/detained under MHA?

Question 5

How could you summarise lots of admissions in the past?

Answer 5

First

Longest

Last

Including: dates, hospital, duration, symptoms, treatment, f/u

Question 6

What is important to ask in drug history

Answer 6

Compliance

Allergies ofc

Question 7

What is extra to ask in FH?

Answer 7

About the relationships with each person, what are they like, how is their health, occupations, where live, ages, names…

Question 8

What to ask in personal history (categories)

Answer 8

Birth

Education

Employment

Relationships

Question 9

What do you ask about birth within personal history?

Answer 9

Grew up / upbringing

Happy or not

Close to who

Education:

Question 10

What do you ask about education in personal history?

Answer 10

Dates, normal schools, enjoy,

Friends

Bullied

Subjects liked

Teachers

Behaviour problems, expelled,
truant

Academic (top, middle bottom)

Aspirations

Results

Question 11

What do you ask about employment in personal history?

Answer 11

For each job ask:

Type job? When ? How long? Enjoy it? Why leave?

Or summarise lots by:

First job? 
 List all other jobs? Duration?
       ever dismissed? When? Why?
 Longest job?
Current job? Pay and promotion?

Question 12

What do you ask about relationships in personal history?

Answer 12

For each relationship ask:
Name? Age? Duration? Good or bad? Why end? On-going contact? Children?

Or summarise lots by:

First partner

List other long term partners (>6 mths)

Longest relationship?

Current partner also ask about character traits and sexual history

Question 13

What do you ask in social history?

Answer 13

Housing

Typical Day

Relationships

Activities of daily living

Shopping, cooking, cleaning, laundry

Support e.g. home care, family, care workers

Occupation, finances

Other activities e.g. church, pets, social clubs, day centres, driving

Question 14

Substance misuse qs?

Answer 14

Smoking

Alcohol (CAGE)

Illicit- what, how, amount, £, duration, impact

Question 15

Forensic history qs

Answer 15

Ever been in trouble with the police?

Drink-driving

Convictions or sentences

Violence or aggression

Question 16

Premorbid personality qs

Answer 16

Forming and maintaining relationships (family, friends, partner).

Character traits: “would you say you’re trusting? or suspicious? Caring? Obsessions? ”

Predominant mood: “How would you describe your mood most of the time?”

Reaction to stress: “when your under pressure how do you cope?”

Hobbies:

Religion or spirituality:

Question 17

After you’ve taken the history from the patient where else should you look for information?

Answer 17

Informant history (NB need permission from pt!)