Psychatric history Flashcards
Main heading to cover in Psychiatric history
Identifying data - consider source and reliability PC HxPC Psy Hx Substance us, abuse and addiction PmHx Medication Allergies Fmhx Developmental Hx from conception to now Social Hx Sexual Hx Review of systems
In HxPC what review of symptoms should be covered
Mood - depression and mania
Anxiety
Psycosis
Other - ADHD, Eating disorders
Questions to ask when screening for depression
SIGECAPS Sleep Interest Guilt Energy Concentration Appetite Psychomotor agitation/retardation Suicidality
Question to ask to screen for Mania
Impulsivity Grandiosity Recklessness excessive energy Reduced need for sleep Increase spending above means talkativeness Racing thoughts Hypersexuality
Screen Q for mixed mania/depression
Irritability, liability
Screen Q for anxeity
anxiety present where, when, who, how long, how frequent Then ask Q to screen for Panic disorder OCD PTSD Social anxiety SImple phobias
Questions for Panic disorders
How long until it peaks?
Somatic symptoms
Increase HR, sweating, SOB, trouble swallowing, sense of doom, fear of recurrence, agoraphobia
Questions for OCD
Checking Cleaning Organising Rituals Hang ups obsessive thinking Counting Rational vs irrational belief.
Questions for PTSD
Nightmares
Flash backs
Startle response
avoidance
Screening questions for psychosis
hallucination - auditory, visual, olfactory, tactile
Paranoia
Delusion - TV, radio, Thought broadcasting, mind control, referential thinking
Pt’s perception - spiritual or cultural context fo symptoms, reality thinking
Questions to ask in Psy Hx
Date, symptoms, duration, frequency, severity Tx - outpt vs inpt, vol vs invol, dosage Suicide Hx self harm HX Forensic/violence/homicidality risk Hx DV Legal Cx Outcome for victim.
Questions to ask to cover substance use, abuse and addiction.
What, date started and stopped, quality, frequency, why they started and stopped and route.
Impact of use on life eg family, friend and work
Screen for alcohol dependency
Readiness for change
Check for drug, medication, Eoth, Tabacco, caffeine, gambling, eating behaviour and internet use.
Screening tool for alcohol dependency
CAGE
- Have you ever Cut down you drinking?
- Have people annoyed you by criticizing your drinking?
- Have you ever felt bad or Guilty about your drinking?
- How soon after waking do u have a drink? Eye opener
Development Hx Questions
Perinatal
Birth
Developmental milestones
Childhood Hx including environment, FM members, Friendships
School and education and extracurricular activities
Childhood physical and sexual abuse
Social Hx questions
Occupation Hx Financial Hx Military Hx Marriage and relationship and kids Legal hx Social - hobbies, interest, pets Cultural or religions influences
