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Psychiatric History

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!

The Routine

Introduce 

Be empathic

PC/HPC

  • Onset, duration, effect on life, events coinciding, solutions tried
  • Depression
  • Suicidal thoughts, plans or actions
  • Psychosis: persecutory, delusions, hallucinations
  • Mania, obsessions/compulsions, anxiety, eating disorders
  • Present circumstances 

    Housing, finance, work, marriage, friends, religion

    FH

    Physical/mental health, relationship to family, personalities in family

    Birth, growth, development

  • Stresses, hobbies, education
  • Jobs, Pychosexual: marriage, sex, orientation
  • Make friends easily? Stress?
  • PMH

    Including psychiatric diseases

    Psychoative substances 

    Forensic

    I.e. criminal activities

    Premorbid personality 

    Attitudes to self and others, moral/religious beliefs, predominant mood ("how would other people describe you"), etc.

    Mental state

    Common Diseases

    Depression

    Divided in to core symptoms and "biological" symptoms.

    Schizophrenia

    Anxiety

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