Psychiatry History & MSE Flashcards
What are the key differences between a psychiatric history and a normal history?
1 - Past psychiatric history
2 - Family history of psychiatric conditions
3 - Personal history
4 - Pre-morbid history
5 - Forensic history
6 - MSE
What are systematic symptoms that should be covered when completing a psychaitric history?
1 - Any changes in your mood?
2 - Have you been feeling anxious or panciky?
3 - Problems with memory/confusion
4 - Abnormal thoughts - odd ideas, paranoia, obsessions
5 - Hallucinations
6 - Thoughts of harming yourself or others
7 - Do you feel you need medication or need to be in hospital
How should psychiatric symptoms be explored?
- Severity and duration
- How they began
- Course of symptoms
- Other related symptoms
If the primary reason a patient presents is persistent low mood, loss of interest or pleasure, fatigue or low energy what other symptoms should be inquired about?
Sleep
Appetite
Concentration
Feeling guilty
Agitated
Slowing of movements
Suicidal thoughts
Lack of confidence
What symptoms should be inquired about during a history in a suspected case if schizophrenia?
Auditory hallucinations
Sensory hallucinations
Disorders of thought
Delusions of perception
Passivity
How should you ask a patient if they have auditory hallucinations?
Do you ever hear voices when there is nobody there?
How should you ask a patient if they are having disordered thoughts?
Do you ever have the feeling that your thoughts are being controlled or taken away from you?
Do you ever feel like your thoughts suddenly stop?
Do you feel like someone is inserting thoughts into your mind?
Do you feel like people can hear your own thoughts?
How do you ask a patient about sensory hallucinations?
Do you ever feel like someone or something is touching you when there is nothing there?
How do you ask a patient about any delusional perceptions they may be having?
Do you ever feel like someone or something is paying particular attention to you?
When you watch TV or listen to the radio, do you feel like the stories are refering to you?
What should you enquire about when discussing a patients previous psychiatric history?
What was it?
Duration?
Treatment?
Ever been detained under the mental health act?
When asking about previous medical history, what conditions should be paid particular attention?
Head injuries
Birth trauma
Epilepsy
When enquiring about a patients personal history, what should you ask about?
Family problems - divorce, abuse
Childhood years - bullying, educational attainment
Occupational history
Relationship history & children
Sexual history
What should be inquired about during a social history in a psych history?
Living circumstances - who is at home?
Occupational circumstances
Financial circumstances
Family/friends support
Interests & activities
What should be asked about in a forensic history ?
Any instances of contact with the police leading to a charge or conviction?
Any previous contact with foresnice psychiatry?
How should you ask a patient about their pre-morbid history?
How would you describe your character prior to this period of illness?
How would your close friends and family describe you?
