Psychiatric Interview

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    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

    Mood up/down

    Anxiety

    Psychosis

    Substance Use

    Gambling

    Legal

      SI/HI

    Dependents

    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

    Descriptor

    Descr

    Thought Blocking

    Talks then stops abruptly

    Goal Directed

    Answers brief, direct

    Circumstantial

    Talks around, but answers

    Tangential

    Never to point

    Loose Associations

    Ideas slip off track to other

    Word Salad

    Random words

     

    • 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
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