History Taking, Examination and Diagnosis Flashcards
What are the objectives of history taking?
Form rapport and gather information
Establish and explore symptoms in context
Explore possible biological and social factors related to the symptoms
Inform and motivate the patient
Begin formulation
What is asked in past psychiatric history?
Past episodes / diagnoses Previous treatments Inter-episode functioning Previous hospital admissions Attempted suicide / repeated DSH Previous detentions under mental health legislation
What is asked in the PMH?
Developmental problems Head injuries Endocrine abnormalities Liver damage, oesophageal varicies + peptic ulcers Vascular risk factors
What is asked about in the forensic history?
Have you ever been in contact with the police?
Offences
Recidivism
Violent or sexual crimes
What is asked in the mental state examination?
Appearance Behaviour Mood Speech Thoughts Beliefs Percepts (illusions, hallucinations in many domains) Suicide/homicide Cognitive function Insight - 3 questions (Are the symptoms due to an illness? is this a mental illness? do they agree with the treatment plan?)
What is psychopathology?
Concerned with abnormal experience, cognition and behaviour
What is descriptive psychopathology?
Categorises the abnormal experience as described by the patient
What is phenomenology?
Refers to 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
What is asked in the mental state examination?
Appearance and behaviour Affect Mood Speech Thinking Perceptual anomaly Cognitive function Insight Risk assessment including suicide and homicide Also consider other test results
What are the 4 sections looked for in a patients thinking?
Speed and tempo
Types of thoughts
Linkage and thought form
Possession of thoughts
What are pseudohallucinations?
Where the person experiences a hallucination but knows that the hallucination is a hallucination and not perceived to be real
