Psychiatric Interview

Psych Interview (see attached doc for alt formatting)

ID – Age, Married? Employment, Nationality

RFR and Method

CC – Subjective in quotations “Police brought me”

HPI:

• Start w/ most recent
• “What is different today compared to other days”
• Also collateral Hx
• EtOH/Substance

Safety:

• “Have you ever had thoughts that life is not worth living?”
• “Have you ever had thoughts about killing yourself?
• Passive Vs. Active
• Self-Care (Driving, Stove, getting lost)

PΨHx:

• Age of first Ψ contact
• Hospitalization
• Past Suicide

MSE

• Appearance (Clothes, Hygeine, etc..)
• Dressed Appr? Well kempt?
• Behaviours
• Psychomotor, ticks?
• Good posture, eye contact?
• Speech
• Rate, tone, flow?

• Mood  (NOW)
• What patient says “I don’t know”
• “1..10 worst to best ever felt”
• Neutral, Euphoric, Depressed, Anxious, Irritable
• Affect (Look at face)
• “Responding to interal stimuli?”
• “Euthymic” full, flat, blunted, in appro.

• Thought Content
• Ideas, Worries, “Repetitive thoughts?”
• Thought insertion/withdrawal
• Delusions? Halluc?
• “No Evidence of psychotic sx?”
• Suicidal/Homicidal ideation?

Allergies

Meds: + Adherence

Substances

PMHx: head Injuries? Seizures?

FH/ FΨHx:

• Make Family Tree w/ ages, deaths, names
• Relationships with each
• History of psych problems?

SHx/PPH:

• Anything in childhood contributing?
• Axis I vs Axis II
• Birth-development-childhood-school-relationships-etc
• Friends/supports
• Employment

• Thought Form

• Perception
• Hallucations
• Illusions (misinterpret)
• Cognition (Can tell a story?)
• Say if “formally tested”
• Orientation (T/P/P)
• Concentration/Attention
• Memory
• Insight (Understand what’s going on?)
• “Do you have a mental illness?”
• “why are you here?
• Judgement
•  “Do you think you need tx?”
• “If you smelled smoke in theatre what would you do?”  “found addressed mail”

Axis I – Clinical Disorders

Axis II – Pesonality Disorders (Mental retardation?)

Axis III – General Medical Conditions

Axis IV – Psychosocial + Environmental

Axis V – Global Assessment of Functioning

Acronyms

Depression:

• M – Mood (Dysphoric) “Depressed, sad, hopeless?”
• S – Sleep (insomnia: initial, middle, terminal)
• I – Interest: loss of interest “Decreased sex drive,…”
• G – Guilt
• E – Energey Level
• C – Concentration
• A – Appetite/ Weight changes?
• P – Psychomotor retardation/agitation “Restless? Agitated? Slowed down?”
• S - Suicidal

 Mania

• G – Grandiosity (inflated self-esteem?)
• S – Sleep
• T – Talkative, pressured?
• P – Painful cons. (money, sex, substance, speeding)
• A – Activities goal directed (productivity)
• I – Ideas that race/flight
• D – Distracted Easily

Delusions – False fixed belief

• Delusions of Reference(TV/radio messages for you)
• Delusions of Persecution(People trying to hurt you?)
• Delusions of Grandiosity(special abilities? Powers?)
• Somatic Delusions(Illness, not found by doctors?)

• Delusions of Guilt(done terrible, deserve punishment?)
• Erotomania(someone secretly in love w you?)
• Delusions of control(someone controlling you?)
• Thought insertion(thoughts in head put from outside?)
• Thought withdrawal(thoughts taken from head)
• Thought broadcasting(others hear thinking)
• Delusions of mind reading

Hallucinations –

• visual, auditory, tactile, olfactory, gustatory

Anxiety

• S– Sweating
• T – Trembling
• U – Unsteady/Dizzy
• D – Derealization (feel not real)
• E – Excessive HR/palpitations
• N – Nausea, abdo discomfort
• T – Tingling/Numbness
• S – Shortness of Breath
• FEAR – Fear of losing control, going crazy, dying
• The 3 C’s – Chest Pain, Choking, Chills/HotFlashes