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Psychiatric history


  • Wash hands
  • Introduce self
  • Ask Patient’s name, DOB and what they like to be called
  • Explain and obtain consent

Presenting complaint

  • Determine symptoms which brought patient in
  • Did they come voluntarily or were they detained
  • Who prompted it (patient, family, friend)

History of presenting complaint

  • Exploreevery symptom
  • Psychiatric system review
    • Psychosis screen (first rank symptoms): 3rd person auditory hallucinations, running commentary auditory hallucinations, delusions of thought/control/perception
    • Depression screen: core (mood, anhedonia), biological (sleep, energy), future (hopelessness, suicidal thoughts)
    • Other: memory loss, anxiety, insight
    • RISK: to self (suicide/self-harm), to others

Past medical history

  • Past psychiatric history
    • Diagnoses
    • First and last episodes
    • How many episodes and admissions (check if voluntary or involuntary and if any to psychiatric intensive care)
    • Previous self-harm/suicide attempts
    • Mental health worker/care co-ordinator
  • Past medical history

Drug history

  • As usual
  • Check compliance

Family history

  • Family psychiatric history
  • Family history of suicide

Social history

  • Alcohol and drug use (VERY IMPORTANT!)
  • Social circumstances
    • Current situation
    • Relationships
    • Dependants and contact with children – determine if their children are safe (who are they with?)
    • Home (support, home state)
    • Finances (benefits, debts)
    • Education/work
    • Coping with activities of daily living
  • Forensic history (especially important if there may be any risk to others), for example:
    • Ever been arrested or in prison?
    • Types of crimes?
    • Longest prison sentence?
    • Any domestic abuse?
  • Personal upbringing history: include if any history of child abuse
  • Pre-morbid personality


Why don’t you test your knowledge?

What are the first rank symptoms of schizophrenia?

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What are the symptoms of depression?

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List some risk factors for suicide?

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Now it’s time for some stations…

  1. Strange behaviour
  2. Psychosis
  3. Anxiety
  4. Eating disorder
  5. And there’s much, much more!

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