1. Lecture Tripoli, Libya Sunday 23rd January 20100 Mental health history taking

2. Mental health history taking Dr Henk Parmentier General Practitioner - South West London, United Kingdom - Wonca Working Party on Mental Health

3. objectives Learn about mental health history taking Learn about psychiatric assessment

4. 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?

5. Assessment A full assessment can take many sessions and take hours But it can be done in a few minutes by a Family Doctor

6. Psychiatric assessment A complete psychiatric requires: Detailed personal history Clear account of current problems Risk assessment Mental state examination Physical examination

7. Psychiatric history Administration: Name Age and sex Address, telephone number Languages Marital status Education occupation

8. Presenting problem What is the current problem? How long has it been going on? What events led up to this presentation?

9. 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?

10. 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

11. Previous medical history Next presentation

12. Drug history Previous drugs: self medication, prescribed drugs, illegal drugs Allergic reactions?

13. 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

14. Family history Ask about individual’s close family and their health status Age, health, occupation, how's the relationship with that person

15. Mental state examination Obtain information about specific aspects of the patient’s mental experiences and behaviour at the time of the interview

16. Appearance and behavious Appearance Attitude Motor behaviour

17. speech Rate Volume Quantity of information

18. Mood and affect Mood: depressed, euphoric, suspicious Affect: restricted, flattened, inapropriate

19. Form of thought Amount of thought and rate of production Continuity Disturbance in language or meaning

20. Content of thought Delusions Suicidal thoughts other

21. perception Hallucinations Other: derealisation, depersonalisation

22. Sensoriumans cognition Level of consiousness Memory: immediate, recent, remote Orientation in place, time and person Concentration

23. insight Awareness of problems