Psychiatric Interview

Greet him by name and introduce yourself. Put him at ease; arrange 6- Family History: MSE: cross-sectional
for a private comfortable setting, and appropriately tell the purpose § Parents (age ,consanguinity, illness) Appearance: age, gender, stated
& duration of the interview. Build good rapport and alliance. § Sibling (age, illness, order of Pt) age, body build, facial expression,
1- ID: § History of (psych, medical, drug posture, dressing, grooming,
Name, age, nationality, sex, marital status, education, occupation, abuse, Rx response, homicide, hygiene, physical abnormalities
residency (where/with whom). suicide, faith healer)
Date of admission through clinic or ER/ Reason of referral § Important family events e.g. death, Attitude: Interested, bored,
2- Source of Information & Reliability divorce, separation & the its impact cooperative, uncooperative,
3- CC: Pt verbatim + duration * Relation between them & patient sarcastic, guarded, hostile,
4- HPI: 7- Personal & Social History: threatening, hostile, seductive,
§ Establish a baseline of mental health (Patient’s level of § Birth: obstetric or prenatal suspicious, over-familiar, critical,
functioning when “well”). difficulties. controlling.
§ Dissect symptoms (onset, duration, severity, stressor, reason of § Development: motor and language,
relapse, precipitating & reliving factors). childhood attitudes & relationships Behavior: Level of activity,
§ Functioning (relations, self-care, school, work, daily activity). with parents, siblings & others, attention (attentive,
§ Don’t forget S.O.A.P (Suicidal & homicidal, Organisity, Addiction, emotional or behavioral difficulties preoccupied, distractible), eye
Psychosis) § School: starting & ending age, level, contact, abnormal behavior:
performance, relations, misconduct Akathisia, Dystonia & EPS, TD,
Depression (5 sx for 2wks) Mood, Loss of interest, tearfulness, Change § Occupation: age, duration, relation, Tics, Tremors (Resting/ Intention/
in Sleep, Psychomotor, Appetite/Weight, Fatigability, Worthlessness performance Postural), Hallucinatory gesture,
/Guilt, Decrease Concentration, Death wishes or Suicide § Social: living situation, financial Choreoathetosis, Compulsions,
state, support Catatonia: 1.Peculiar movements
Mania (3-4 sx for 1wk) Mood, impulsivity, Inflated self-esteem or § Psychosexual: puberty, menstrual (bizarre Postures/ stereotyped
grandiosity, Decrease sleep, Talkative, Flight of Ideas, Distractibility, reg., sig relationships, abuse, movement/ mannerisms/
Hyperactivity, Excessive painful activities, Hypersexuality dysfunction grimacing), 2.Rigidity (lead Pipe/
§ Marital: age, consanguinity, cogwheel/ clasp Knife),
Psychosis 5 hallucinations (Auditory, Visual, Tactile, Olfactory, children, current pregnancy, relation 3.Echopraxia, 4.Negativism,
Gustatory), 10 Delusions (Paranoia, Reference, Grandeur, Somatic, past & current 5.Catalepsy, 6.Excitment.
Control, Thought Broadcasting, Thought Withdrawal, Thought § Forensic: arrest, prison & why
Insertion, Guilt, Nihilistic) § Substance Use Dis: Type of Speech: Coherent, relevant, rate
substances, onset, duration, (pressured, slowed, regular),
Suicide relapses, tolerance, intoxication, amount, volume, articulation
1- How do you feel about the future? withdrawal, reasons of cutting down (stuttering/ slurred/ mumbling)
2- Do things feel completely hopeless, or is there still a reason to or relapse. Participation in
keep trying? outpatient or inpatient drug rehab Mood & Affect: Type (euthymic/
3- Do you feel that life's not worth living? programs. elated/ irritable/ low/ anxious),
4- Sometimes when people r feeling low they have thoughts about Intensity (restricted/ blunt/ flat/
harming themselves. Have u felt like this? * detail & reason for of any stop of exaggerated), Stability (labile/
5- What did you think you might do? Have you made any plans? (school, change or quit of job, divorce & sustained), Reactivity (reactive/
6- Have you ever made an attempt? other wife's) non-reactive), Appropriate,
7- How do you feel about this today? Congruence
8- What would stop you from harming yourself?
9- Do you have thoughts about harming others? Thought form: Well organized,
5- Past History: 8- Pre-morbid Personality: Poverty, Circumstantial,
§ Psychiatric: Any previous psychiatric illness (nature, extent, § Described by other? self-feeling? Tangential, Flight of Ideas, Loss of
dates, treatment, outcome, psychiatrist, patient’s reaction and § Prevailing mood Association, Thought Blocking,
attitude). Episodes reasons, F/U, admissions (number, § Hobbies, interests, recreations Fragmentation, Verbigeration,
duration), management (what, dose, compliance, ECT, depot, § Moral or religious beliefs & practice Echolalia, Word Salad, Clang
CBT, response, S/E), suicide hx or self-injury. § Impulsivity associations, Neologisms
§ Medical and Surgical: Systematic review (nature, extent, dates, § Coping with stress
treatment, outcome, & patient’s reaction & attitude). § Extroverted, introverted, Social skills Thought content: Delusion,
Head trauma, seizure, thyroid, heart disease, pregnancy, § Interpersonal relations width/depth Overvalued ideas, Preoccupation,
menstrual or menopausal difficulties, cortisone, and allergy. § Responsibility Death wishes, Suicidal/ Self-harm
/ Homicidal thoughts, Poverty,
Cognition: Consciousness, Orientation, Attention/Concentration (serial 7s test, spell backward), Memory:
Obsessions
Immediate (repeat words) Short-term ("banana, clock, car" then after 5 min ask to recall), Recent (last few days-
months life events), Remote (personal or public events), Abstract thinking (Proverbs or Similarities & difference),
Perception: Hallucination,
Knowledge, IQ, visuospatial ability
Illusion, Depersonalization,
derealization, Strange experience
Insight: Do you believe that: 1.You have abnormal experiences? 2.Your abnormal experiences are symptoms of
(Déjà vu/ Jamais vu)
illness? 3.The illness is psychiatric? 4.Psychiatric treatment might benefit you?

Judgment: what would you do after discharge? or if you smelled smoke in a crowded place?

2020 Dr. Deemah A AlAteeq [email protected]