Psychiatric history

Question 1

Presenting complaint

Answer 1

in own words (briefly)

Sometimes they don’t have any complaint - think that they are well

Question 2

For history of present illness, ask:

Answer 2

When did it start?
Precipitating events?
How did it develop?
Associated symptoms?

How is it affecting your daily life
Has any help or investigations been sought for and the response

Question 3

Past psychiatric history

Answer 3

Psychiatric admissions
Treatments
Any past self-harm and suicide attempts

Question 4

Family history

Answer 4

Siblings, parents - age, health, employment

Question 5

Medical history

Answer 5

Major illnesses with current treatment and medication

Allergy?

Question 6

Substance misuse

Answer 6

Tobacco
Alcohol
Illicit drugs

Past and current use, with effects (withdrawal, dependence)

Question 7

Personal history

Answer 7

Childhood – birth, developmental milestones, family atmosphere
School & education – primary and secondary schooling, relationship with teachers and peers, problems at school (academic, behavioural e.g. truancy, school refusal), age when left school, any further training or courses

Occupations – job taken, for how long, why left, and for how long being unemployed

Psychosexual and relationship history – past and current relationship, marital history, any children (ages and contact – remember children safeguarding), sexual orientation and difficulties if relevant

Past history of emotional, sexual and physical abuse if appropriate (have you ever been psychologically, physically, or sexually abused by someone)

Question 8

Forensic history

Answer 8

all offences, whether convicted or not
eg.
arrest or caution by police
under probation
prison sentence

Question 9

Premorbid personality

Answer 9

personality BEFORE they become unwell

Attitudes to others in relationships
Attitudes to oneself
Any predominant mood and stability
Leisure activities, and interests
Individual strengths and abilities

“How would you describe your normal self?”
“How would other people describe you?”

Question 10

Social circumstances

Answer 10

Where the person is living
Any children in the house
The financial situation
Support network

Receiving any benefits?
Any carer identified and is there support for the carer