Often an OSCE station. The below is a guide of a full
psychiatric history, but there is unlikely to be enough time in a 10
minutes to complete it. The best OSCE strategy is to ask questions to
get a feeling of the diagnoses, then to ask questions relating to this
diagnosis (the symptoms of the major psychiatric consitions are given
below) including the social impact. Once you have done that, keep
asking any of the below questions until you run out of time!
Onset, duration, effect on life, events coinciding, solutions
Suicidal thoughts, plans or actions
Psychosis: persecutory, delusions, hallucinations
Mania, obsessions/compulsions, anxiety, eating disorders
Housing, finance, work, marriage, friends, religion
Physical/mental health, relationship to family, personalities in family
Birth, growth, development
Stresses, hobbies, education
Jobs, Pychosexual: marriage, sex, orientation
Make friends easily? Stress?
Including psychiatric diseases
I.e. criminal activities
Attitudes to self and others, moral/religious beliefs, predominant
mood ("how would other people describe you"), etc.
General appearance & behaviour
Mode of speech
Unusual experiences or hallucinations
Divided in to core symptoms and "biological" symptoms.
↓Mood, anhedonia (lack of enjoyment), worthlessness/self-denigration, guilt, fatigue,
Biological: early morning waking, ↓apetite/weight,
↓sex, psychomotor retardation), suicidal intent.
, esp thought echo or 3rd
Thought withdrawal, insertion or
(delusions about external control of thought).
(the delusion that others can
hear ones thoughts).
(abnormal significance of a normal event ('the lights changed & I
realised I was the son of god')).
External control of
sensations & actions are under external control).
: Activity, motivation, social withdrawal, emotional
Restlessness, Fatigue, ↓concentration, Irritability, Muscle
tension (eg. trembling), Disturbed sleep.
Types: Panic disorder agoraphobia Post traumatic stress disorder,
OCD, Phobia, Social phobia, Acute stress disorder.