History Taking, HxPC guided differentials

Question 1

In the last 12 months:

have you felt compelled to take alcohol or drugs?

Do you have difficulty controlling how much you take, how often you take it and stopping?

Do you find that if you stop taking it you experience negative side effects such as sweating tremor seizure?

Patient answers yes to all these questions
Which syndrome is this indicative of?

Answer 1

Dependence syndrome (F10 to F19)

Question 2

HxPC
Tolerance
Do you find that you have to take more of the substance to get the effect you are looking for?

HxPC
Tolerance
Do you find that you are neglecting your other interests to obtain and take more of the substance?

HxPC
Control
Do you keep taking the substance even though you know it is hurting you?

Patient answers yes to all these questions

Which syndrome is this indicative of?

Answer 2

Dependence syndrome (F10 to F19)

Question 3

HxPC
T - timing
How long have you been feeling worried anxious for?

HxPC
Do you find that the anxiety is difficult to control?

SHx
Is your anxiety affecting your ability to function in day to day activities

Answer 3

Generalised Anxiety Disorder

Question 4

HxPC
Associated Symptoms
Have you noticed any change in your behaviour?
Aggression Disinhibition

Have you seen anything that others haven’t been able to see?
Visual Hallucination

Do you ever worry that someone is coming after you?
Persecutory Delusions

Patient answers yes to all questions

Name a condition that would explain the symptoms

Answer 4

Dementia

Delirium

Question 5

HxPC
Associated Symptoms

Any problems with your memory?

Any difficulties with speech or communication?

Any difficulty recognising familiar places or people?

Patient answers yes to all questions

Name a condition that would explain the symptoms

Answer 5

Dementia

Delirium

Question 6

Most common type of dementia

Answer 6

Alzheimer’s disease