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Psychiatry > History Taking > Flashcards

History Taking Flashcards

1
Q

What do you need to ask about in a past psychiatric history?

A 
Past episodes/ diagnoses/ contacts,
Previous treatments,
Inter-episode functioning,
Previous admissions to hospital,
Attempted suicide/ repeated DSH,
Previous detentions under Mental Health Legislation
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2
Q

Relevant diseases to ask about in past medical history that can be relevant with psychiatry

A 
Developmental problems, 
Head injuries, 
Endocrine abnormalities, 
Liver damage, oesophageal varices, peptic ulcers, 
Vascular risk factors
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3
Q

Things to ask about in social history section of psychiatric history?

A 
Social circumstances including occupation, 
Current financial situation/ stressors, 
Smoking/ alcohol/ illicit drug use, 
Current relationship/ stressors,
Children-contact
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4
Q

what sections are added to a psychiatric history that you wouldn’t find in a normal history?

A

Alcohol/ illicit drug history,
Personal history,
Forensic history,
Pre-morbid personality

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5
Q

Questions to ask in alcohol/ illicit drug section of psychiatric history

A 
Regular or intermittent,
Amount,
Pattern, 
Dependence/ withdrawal history,
Impact on work, relationships, money, police, 
Screening questionnaires
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6
Q

Questions to ask in personal history section of psychiatric history

A 
Developmental milestones, 
Early life, 
Schooling, 
Occupational, 
Relationships,
Financial,
Friendships, hobbies and interests
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7
Q

Questions to ask in forensic section of psychiatric history

A

Offences including sentences,
Recidivism (reoffences),
Particular attention to violent or sexual crimes

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8
Q

Questions to ask in pre-morbid personality section of psychiatric history

A

Corroboration,

Emphasis on consistent patterns of behaviour, interaction, mood

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9
Q

What are you examining in mental state examination?

A 
Appearance, 
Behaviour, 
Mood, 
Speech,
Thoughts, 
Beliefs, 
Percepts,
Suicide/ homicide, 
Cognitive function, 
Insight
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10
Q

What to look at in behaviour MSE of psychiatric patient

A 
Greeting, 
Non verbal cues, 
Gesturing,
Abnormal movements,
Cooperative, 
Rapport
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11
Q

What to look at in mood MSE of psychiatric patient

A

Eye contact,
Objective manifestation of mood,
Mood rating,
Psychomotor function

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12
Q

What to look at in speech MSE of psychiatric patient

A 
Spontaneity, 
Volume, 
Rate, 
Rhythm,
Tone, 
Dysarthria, 
Dysphasia
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13
Q

What to look at in thoughts MSE of psychiatric patient

A

Any external manifestations of thoughts,
Phobias,
Obsessions,
Flight of ideas,
Formal thought disorder- broadcast, echo, insertion, block, withdrawal,
Knight’s move, derailment, loosening

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14
Q

What to look at in beliefs MSE of psychiatric patient

A

Preoccupations,
Over valued ideas,
Delusional beliefs

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15
Q

What to look at in percepts MSE of psychiatric patient

A

Illusions,
Hallucinations,
Look at different domains- auditory, visual, somatic/ tactile, olfactory and gustatory

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16
Q

What to look at in suicide/ homicide MSE of psychiatric patient

A 
Ask about any suicidal thoughts, 
Ideation,
Intent, 
Plans- vague, detailed, specific, already in motion, 
Homicidal risk
17
Q

What to look at in congitive function MSE of psychiatric patient

A

Orientation- time, place, person,
Attention/ concentration,
Short term memory- 3 objects
Long term memory- personal history

18
Q

What to look at in insight MSE of psychiatric patient

A

Ask them 3 questions:
Are your symptoms due to illness?
Is this a mental illness?
Do they agree with treatment/ Mx plan

19
Q

What is psychopathology concerned with?

A

Abnormal experience, cognition and behaviour

20
Q

Define descriptive psychopathology

A

Describes and categorises the abnormal experience as described by the patient

21
Q

Define phenomenology

A

The observation and understanding of the psychological event or phenomenon so that the observer can as far as possible know what the patients experience feels like

22
Q

What does SCAN stand for?

A

Schedules for
Clinical
Assessment in
Neuropsychiatry

23
Q

In appearance and behaviour in a MSE what are some clinical signs that can be indicators of a psychiatric condition?

A

Responding to unseen stimuli,
Evidence of side effects of medication,
Evidence of intoxication,
Movement disorder (catatonia)

24
Q

“Affect” in psychiatric history refers to what?

A

The emotions conveyed and observed objectively during the interview

25
Q

Thinking in a psychiatric patient can be organised into 4 sections that need to be considered

A

Speed and tempo of thoughts,
Types of thoughts demonstrated,
Linkage and thought form,
Possession of thoughts

26
Q

Different types of thoughts displayed at MSE

A 
Preoccupations,
Phobias,
Obsessions, 
Overvalued ideas,
Delusions (primary or secondary)
27
Q

What is a delusion

A

An unshakeable idea or belief which is out of keeping with the persons social and cultural background; it is held with extraordinary conviction

28
Q

Examples of types of delusions?

A

Grandiose,
Paranoid,
Hypochondriacal,
Self referential

29
Q

What is meant by a formal thought disorder?

A

A pattern of interruption or disorganisation of thought processes, can be described more specifically as:
Thought blocking,
Fusion,
Loosening of associations,
Tangential thinking,
Derailment of thoughts, or knights move thinking

30
Q

What are the 3 classes of perceptual disturbance?

A

Hallucinations,
Pseudohallucinations,
Illusions

31
Q

Characteristics of a hallucination?

A

Have the full force and clarity of true perception,
Located in external space,
No external stimulus,
Not willed or controlled

32
Q

3 factors that formulate a psychiatric condition?

A

Biological,
Psychological,
Social

33
Q

What are the key symptoms of a depressive episode?

A

Persistent sadness or low mood,
Loss of interest or pleasure,
Fatigue or low energy

(For at least 2 weeks)

34
Q

If key symptoms of a depressive episode are present what should you ask about?

A 
Associated symptoms:
Disturbed sleep,
Poor concentration or indecisiveness, 
Low self-confidence,
Poor or increased appetite, 
Suicidal thoughts or acts, 
Agitation or slowing of movements, 
Guilt or self-blame
35
Q

What are the classes of a depressive episode?

A 
Mild depression (4 symptoms)
Moderate depression (5-6 symptoms)
Severe depression (seven or more)

Psychiatry (23 decks)

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