Psychiatric History

Question 1

How many topics make up a psychiatric history?

Answer 1

12

Question 2

What are the first 4 topics that make up a psychiatric history?

Answer 2

Presenting Complaint
History of presenting Complaint
Past Psychiatric History
Past Medical History

Question 3

What are the second 4 topics that make up a psychiatric history?

Answer 3

Medication/drug history
Family history
Personal history
Substance misuse

Question 4

What are the last 4 topics that make up a psychiatric history?

Answer 4

Forensic history
Social history
Premorbid personality
Collateral history

Question 5

How do you initially present a patient?

Answer 5

Who - age, gender, by themselves or with anyone
Where - A&E/ward/clinic
How did they get there - by themselves? family member? police/ambulance? admitted to ward formally or informally?

Question 6

What is the presenting complaint in a psychiatric history? (ward/A&E/clinic)

Answer 6

Ward - reason for admission
A&E - reason for attendance
Clinic - patient’s main concern

Question 7

What are the 3 main things necessary in the HPC?

Answer 7

What are all the issues/symptoms/limitations associated with it?
How long the problem has gone on for?
What happened in the build up to it?

Question 8

What are the 4 points in a past psychiatric history?

Answer 8

Any previous diagnoses
Previous/current treatments
Admissions (formal or informal)
Risk events

Question 9

Relevant components of medical history to psychiatric history?

Answer 9

Medical conditions that CAUSE psychiatric symptoms
Psychiatric illness AFTER having a medical condition
Medications causing psychiatric symptoms
Medical conditions that may interfere with psychotropic medication (e.g. diabetes)

Question 10

What should a personal history contain?

Answer 10

Pregnancy/birth/early development - any complications
Home life during childhood
Academic - ability, friends, bullying, behaviour problems
Jobs - types, reasons for leaving, relationship with colleagues
Relationships

Look for themes

Question 11

Questions to ask about substance misuse?

Answer 11

Any current use of the main 3
Age of starting
Pattern of use
Harmful use (problems caused by use)
Dependance
Medical complications

Question 12

4 questions for forensic history?

Answer 12

Any trouble with police?
Arrested/charged/convicted?
Any history of violence without getting in trouble?
Any link between forensic history and mental illness? (key to establish if violence of crime due to or independent of mental illness)

Question 13

4 areas should be covered in social history?

Answer 13

Current living situation
Current working/studying situation
Social network
Hobbies, interests

Question 14

Which 2 POVs do you want to establish premorbid personality?

Answer 14

Patient’s - what were you like before you became unwell?

Family/friends - how would your friends/family describe you?

Question 15

How do you do a collateral information history?

Answer 15

It’s not a history as such, but a gathering of information from other sources - ambulance crew, police, person the patient is with