Psychiatric Symptoms - exploration

Question 1

Depression

Answer 1

Core: Mood and Anhedonia
Biological: sleep energy appetite
Future: inc risk hopelessness suicidal thoughts plans for suicide
Others history of mania hypomania

Question 2

Anxiety

Answer 2

Timing: onset and duration
Episodic/constant, triggers, effect on life, frequency.
Somatic symptoms: palpitations, breathlessness, chest tightness, sweating, dizziness.
Associated psychological symptoms: depression screen, stress, worry, avoidance
Psychiatric differential questions: Obsessions and compulsions post-traumatic stress disorder symptoms: psychological trauma, flashbacks, nightmares hyper-arousal.
Organic differential questions hypothyroidism symptoms ACS symptoms

Question 3

Auditory Hallucinations

Answer 3

Auditory hallucinations: male/female, Familiar/unfamiliar, always same/different, when heard, what were you doing?
Real Hallucination or pseudo? Inside or outside the head?
2nd person or 3rd person: talking to you or about you?
What they say: inc commands
Risk to self/others.
Associated psychiatric symptoms.

Question 4

Delusions

Answer 4

Expand and challenge the delusion
Risk to self or others
Associated psychiatric symptoms.

Question 5

Memory Loss

Answer 5

Get a collateral history
Short or long term insight and concerns
Functional levels for example washing dressing
Perform a cognitive assessment for example mini mental state exam
Risk to self and others

Question 6

Eating disorders

Answer 6

BMI, weight, height
Symptoms: avoidance of weight gain/need to lose weight Preoccupation with appearance
Efforts to purge: vomiting/laxatives/exercise.
Any binge eating/fasting

Food diary: what they eat each day.
Results: menstrual cycle disturbance, poor dental hygiene Screen for depression (including risk to self), diabetes and thyroid problems.