Psychiatric history Flashcards
What are the 12 categories in a psychiatric history?
Reason for referral Complaints Present illness Past psych history PMH FH Personal history Reproductive history Personality DH Forensic history Systemic review
What should be included in past psyche history?
Previous episodes of psychiatric illness and their treatments, including responses and adverse reactions. Always ask about previous episodes of self-harm
What psyche thing is important in the PMH?
Emotional reactions to illness and procedures.
What is of particular interest in the FH?
The parents or carers cared (physically and emotionally) for the patient, and the occurrence of both mental and physical illnesses in first-degree relatives.
What is the personal history?
A short biography that covers: Childhood difficulties including both abuse and neglect Educational problems (e.g. bullying and truanting) Qualifications (to judge premorbid intelligence) Job problems Sexual relationships Children Present housing Financial situation Bereavements and life stresses
Who should you ask a reproductive history from?
Women
What should a reproductive history include?
Menstrual problems, pregnancies, terminations, miscarriages, contraception and the menopause, if relevant.
Why is personality important?
May help to determine prognosis
What are you looking for in personality?
Is the patient generally a worrier, shy, introverted, dependent on others, passive, aggressive, irritable, over-emotional, prone to moodiness, conscientious, or perfectionist? These are all personality traits that may predict a poorer outcome in both medical and psychiatric disorders.
What are you looking for in DH?
Prescribed and over-the-counter medication, the use (units per week) of alcohol, tobacco, caffeine, and illicit drugs.
What should you say before taking a forensic history?
Explain that you need to ask about this since ill-health can sometimes lead to problems with the law.
WHat should you ask in the forensic history?
Particularly note any violent or sexual offences. This is part of a risk assessment and is necessary in order to assess potential risks to those close to the patient as well as staff. Ask the patient what is the worst harm they have ever inflicted on someone else, which will give an indication of the potential for violence.
