Basic Notes in Psychiatry

Michael Levi

• Publisher: CRC Press
• Year: 2019
• eBook ISBN: 9781315357508
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Junior hospital psychiatrists, general practitioners and medical students will find this book a valuable study aid, as will psychiatric nurses, psychiatric social workers, psychiatric occupational therapists and clinical psychologists.

CHAPTER 1

The history, mental
state examination
and formulation

As in any branch of medicine, psychiatry begins with taking a good history and examining the patient. The history is very similar in format to that taken in general medicine, while the mental state examination is something very particular to psychiatry. Having done both of these, it is then necessary to provide a formulation – i.e. a summary of the case presented in an integrated or synthesised fashion. This chapter deals with, in turn, the history, the mental state examination and the formulation.

The history

Age/Marital Status/Occupation

Source of referral

1 PC/HPC (presenting complaint/history of the presenting complaint): Principal symptoms or complaints and their duration; associated disturbance in appetite, weight, sleep and sexual drive; effects on patient’s ability to cope socially or with work.

2 PPH (past psychiatric history):

Previous hospital admissions with psychiatric illness. Treatment given.

How well did patient remain in between admissions?

3 PMH/PSH (past medical history/past surgical history):

Previous hospital admissions with physical illness or for operations.

4 FH (family history):

(a) Mother and father – current age or, if dead, age at death and cause of death; occupations.

(b) Sisters and brothers – names, ages, marital status, occupation.

(c) FPH (family psychiatric history) – history of any psychiatric illness in the family.

(d) FMH (family medical history) – history of any physical illness in the family.

(e) Current relationships – with parents, siblings and other relatives.

5 PH (personal history) – born and bred:

(a) Birth – any prematurity or low birth weight; any difficulties during delivery.

(b) Pre-school development – any delay in achieving milestones; any separation from parents; relationships with parents, siblings, other children and adults at this age.

(c) School – age of starting and finishing school; type of school attended; academic qualifications; relationships with pupils and teachers.

(d) Occupations – chronological list of jobs; if multiple changes, enquire about the reasons; relationships with workmates and superiors.

(e) Psychosexual history – age of onset of puberty; first steady relationship; first sexual intercourse; any evidence of physical, sexual or emotional abuse; if married, age at marriage and age of spouse at marriage; any psychiatric or physical illness in spouse; relationship with spouse; if children, give chronological list of their names, age and sex; any psychiatric or physical illness in children; relationship with children.

6 Smoke – current and past smoking habits.

7 Drink – current and past drinking habits.

8 Drugs – drugs, medicines or tablets patient is currently taking; any abuse of illicit drugs (e.g. cannabis, amphetamines, opiates).

9 Allergies – any known allergies.

10 Social circumstances – current type of residence (e.g. flat, house); composition of household.

11 Forensic history – any trouble with the law or police; any conviction...

Table of contents

• Cover Page
• Half Title
• Previous books by the same author
• Title Page
• Copyright Page
• Contents
• Foreword
• Preface
• Introduction
• 1 The history, mental state examination and formulation
• 2 The symptoms and signs of mental illness
• 3 Personality disorders
• 4 Anxiety disorders
• 5 Dissociative (conversion) disorders
• 6 Hypochondriacal disorders
• 7 Delusional disorders
• 8 Affective disorders
• 9 Schizophrenia
• 10 Organic disorders
• 11 Eating disorders
• 12 Alcohol and drug dependence
• 13 Psychiatric emergencies
• Index