Psychiatric History Taking, Mental State Examination and Making a Diagnosis Flashcards
what additionaly parts of a history are included for a psychiatric history?
- Presenting Complaint(s)
- History of the Presenting Complaint(s)
- Past Psychiatric History
- Past Medical History
- Current and Recent Medication
- Social History - alcohol & drug use; smoking; social circumstances; occupation
- Family History
- Forensic History
-
Personal History:
Developmental milestones
Schooling/Education
Occupational history
Relationships
Pre-morbid Personality
what would you include in a past psychiatric history?
- past episodes/diagnoses/contacts
- previous treatments (psychological, drug and physical)
- inter-episode functioning
- previous admissions to hospital
- attempted suicide/repeated self-harm
- previous detentions under mental health legislation
what clues could you look for in a past medical history of a psychiatric patient?
- developmental problems
- head injuries
- endocrine abnormalities
- liver damage, oesophageal varices, peptic ulcers
- vascular risk factors
what would you include in a forensic history?
- ‘Have you ever been in contact with the police? Charged with any crime?’
- offences including sentences
- recidivism
- particular attention to violen or sexual crimes
what examination might be required when you have taken the psychiatric history?
Mental State Examination
what areas does a mental state examination include?
- appearance & behaviour
- speech
- mood (subjective to patient) and affect (observed objectively)
- abnormal thoughts
- abnormal beliefs
- abnormal perceptions e.g. hallucinations, illusions, pseudohallucinations
- cognitive function
- suicide/homicide risk assessment
- insight: are symptoms due to illness? is this a mental illness? do they agree with treatment/Mx plan?
Psychopathology is concerned with…
abnormal experience, cognition and behaviour.
Descriptive psychopathology describes…
and categorises the abnorml experience as described by the patient.
Phenomenology in psychiatry refers to…
the observation and understanding of the psychological event or phenomenon so that the observer can as far as possible know what the patient’s experience feels like.
what is formal thought disorder?
A pattern of interruption or disorganisation of thought processes is broadly referred to as formal thought disorder, and can be described more specifically as:
- thought blocking,
- fusion,
- loosening of associations,
- tangential thinking,
- derailment of thought, or knight’s move thinking.
Hallucination characteristics
- have the full force and clarity of true perception
- located in external space
- no external stimulus
- not willed or controlled
5 special senses:
- auditory or visual
- tactile
- olfactory and gustatory
what criteria is used to diagnose a depressive episode and its severity?
ICD-11 for NHS scotland
