Psychiatry History Flashcards
What is the overall structure of a Psychiatric history?
Introduction
Presenting complaint History of presenting complaint [Psych screen] Past psychiatric history Past medical history Medications + side effects Allergies
Family history Personal history (6 subcategories) Forensic history Social history Premorbid personality
Collateral history
What are the subcategories of the personal history?
Birth and development Family background and early childhood Education Occupation history Psychosexual history and relationships Substance misuse
What do you include in the family history?
Draw a genogram:
Name, Age, Occupation
Mental illness
Physical illness
Deaths: Age and cause
Relationships, employment, social circumstances
Substance misuseWhat do you ask in the social history?
Housing: Type, rented/owned, flatmates Finances, including benefits Occupation/Training Daily activities Carers
What do you ask in the forensic history?
Have you ever been in any trouble with the police?
Offences
Seriousness, convictions, sentences.
Make clear note of Violent or Sexual offences
Think about:
Any offences that may have been committed while unwell.
Any forensic issues that may come about because of the illness.
What do you ask about the premorbid personality?
Before this all happened, what sort of person were you?
How would you describe yourself?
How would your friends describe you?
How do you cope under pressure?
Do you have any religious or moral beliefs?
Activities and interests.
What do you ask about in the birth and development section of the personal history?
Were there any problems with your mother’s pregnancy or your birth?
Did you walk and talk at the normal ages?
Prematurity
Labour: complications, birth trauma, interventions,
Time in special care, not able to go home immediately?
Any paediatric follow-up?
What do you ask about in the childhood and upbringing section of the personal history?
Were you seriously ill during your childhood?
Were there any points where you were away from your family for a long time?
What was it like growing up in your family?
What were your parents or siblings like? How did you get on with them?
Was childhood a happy or a difficult time for you?
What do you ask about in the education section of the personal history?
At what age did you finish school?
What grades did you get?
What was it like going to school?
Did you have any problems at school?
Specific others:
What were your friendships like?
Were you shy or outgoing?
Were you bullied, or did anything traumatic happen at school?
Did you get into trouble for bullying others? Skipping school?
Did you get on with teachers?
Were you near the top, middle or bottom of your class?
What do you ask about in the occupation section of the personal history?
List of jobs, chronologically.
Duration
Reason for leaving.
Did you enjoy work?
Any patterns
What do you ask in the psychosexual and relationships section of the personal history?
List relationships chronologically
Longest relationship? What happened?
How were the relationships? Can the patient see any patterns?
Age of first intercourse, number of sexual partners
What do you ask in the substance misuse section of the personal history?
Drugs: approach each individually.
Route
Dose
Changes over time
Attempts at abstinence
Formal detoxifications
Alcohol
Cigarettes
