Carpe Diem HELSINKI Meeting 23/24 June 2004 NUID CWRR Report Bruen, Parmentier.
Parmentier 01
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Transcript of Parmentier 01
Lecture Tripoli, Libya
Sunday 23rd January 20100
Mental health history taking
Dr Henk Parmentier
General Practitioner
- South West London, United Kingdom
- Wonca Working Party on Mental Health
Mental health history taking
objectives
Learn about mental health history
taking
Learn about psychiatric assessment
assessment
Questions to answer:
Does the patient has a mental health
problem?
What is the problem?
What is the treatment?
Can I give the treatment?
Is the patient happy to have the
treatment?
Assessment
A full assessment can take many
sessions and take hours
But it can be done in a few minutes by
a Family Doctor
Psychiatric assessment
A complete psychiatric requires:
Detailed personal history
Clear account of current problems
Risk assessment
Mental state examination
Physical examination
Psychiatric history
Administration:
Name
Age and sex
Address, telephone number
Languages
Marital status
Education
occupation
Presenting problem
What is the current problem?
How long has it been going on?
What events led up to this
presentation?
History of present illness
What are the specific symptoms and
for how long?
Is there a relationship with social
stressors / physical illness?
Disturbances in mood?, appetite?,
sleep?, sexual drive?
Has any treatment been given yet?
Personal history
Covers as much information about the
individual’s life from childhood to
present time
Pregnancy, birth, child behaviour,
development, education, relationships
Work history: how many jobs
Marital status: children
Criminal activities
Previous medical history
Next presentation
Drug history
Previous drugs: self medication,
prescribed drugs, illegal drugs
Allergic reactions?
Premorbid personality
how does the patient describe his
personality before getting unwel?
Mood, temperament, character traits,
confedence, religious believes, ambition
Social relationships with family, friends
and at work
Family history
Ask about individual’s close family and
their health status
Age, health, occupation, how's the
relationship with that person
Mental state examination
Obtain information about specific
aspects of the patient’s mental
experiences and behaviour at the time
of the interview
Appearance and behavious
Appearance
Attitude
Motor behaviour
speech
Rate
Volume
Quantity of information
Mood and affect
Mood: depressed, euphoric,
suspicious
Affect: restricted, flattened,
inapropriate
Form of thought
Amount of thought and rate of
production
Continuity
Disturbance in language or meaning
Content of thought
Delusions
Suicidal thoughts
other
perception
Hallucinations
Other: derealisation, depersonalisation
Sensorium ans cognition
Level of consiousness
Memory: immediate, recent, remote
Orientation in place, time and person
Concentration
insight
Awareness of problems