History Taking

Question 1

What are two fundamental components in psychiatric interviewing?

Answer 1

• Collection of clinical data (History and exam)

- Intuitive understanding of patient as an individual

Question 2

What are some important factors to consider in the setting of a psychiatric interview?

Answer 2

• Importance of privacy
• Informal setting, respect personal space
• Easy exits

Question 3

What are the components of a psychiatric history?

Answer 3

Presenting Complaint(s)
History of the Presenting Complaint(s)
Past Psychiatric History
Past Medical History
Current and Recent Medication
Social History
Family History
Personal History
Forensic History

Question 4

What are the components of personal history?

Answer 4

• Developmental milestones
• Schooling/Education
• Occupational history
• Relationships
• Pre-morbid Personality

Question 5

What specific past medical history may be important to ask about in a psychiatric history?

Answer 5

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

Question 6

What are the components of the Mental State Examination (MSE)?

Answer 6

Appearance 
Behaviour
Mood
Speech
Thoughts
Beliefs
Percepts
Suicide/Homicide
Cognitive function
Insight

Question 7

List some abnormal movements that may be noted on a mental state examination?

Answer 7

Tremor
Choreioathetoid movments
Posturing
Akathisia

Question 8

What physical sign may be used to objectively assess mood?

Answer 8

Affect

Ranges from flattened to labile

Question 9

What is dysphasia?

Answer 9

Deficiency in generation of speech

Question 10

What is dysarthria?

Answer 10

Slurred, slow speech

Question 11

List some examples of abnormal thoughts

Answer 11

• Close relationship to speech - external manifestation of thoughts
• Phobias
• Obsessions
• Flight of ideas
• Formal thought disorder - broadcast, echo, insertion, block, withdrawal
• Knight’s move, derailment, loosening, tangenital thinking

Question 12

List some abnormal belief types

Answer 12

• Preoccupations
• Over valued ideas
• Delusional beliefs - fixed, false belief out of cultural context; extraordinary conviction

Question 13

What is the difference between an illusion and a hallucination?

Answer 13

Illusion - there is a stimulus present. One thing will be perceived as another,

Hallucination - no external stimulus present. Full force and clarity of true perception

Question 14

What tests can specifically be used if concerned about cognitive function?

Answer 14

Objective tests eg

MSQ, MMSE, MOCA, FAS, Clock drawing, executive function tests

Question 15

Give examples of conditions in which blunted affect may be seen?

Answer 15

• Schizophrenia

- Parkinson’s

Question 16

What types of delusions are there?

Answer 16

• Grandiose
• Persecutory (paranoid)
• Hypochondriacal
• Self referential
• Nihilistic

Question 17

What condition is abnormal possession of thoughts commonly reported?

Answer 17

Schizophrenia

Question 18

What are the 3 classes of perceptual disturbance?

Answer 18

Hallucinations
Pseudohallucinations
Illusions

Question 19

What does hypnopompic mean?

Answer 19

On waking

Question 20

What does hypnogogic mean?

Answer 20

On going to sleep

Question 21

What three fields are looked at for orientation when considering cognitive function?

Answer 21

Oriented to:

• Time
• Place
• Person

Question 22

What three categories of cause should be considered when formulating a psychiatric history case?

Answer 22

Biological
Psychological
Social

(Should be considered in terms of predisposing, precipitating and perpetuating factors)