Psychiatric History-Taking

Triggers, type of self-harm, severity of harm

Fixed false beliefs held involuntarily

Incorrect sensory experience

Derailment, tangientiality, neologisms

Amotivation, social withdrawal, blunt affect

Involuntary psychomotor abnormalities

As interpreted by the patient e.g. pain

Which drugs, who prescribes them, effect

When, why, length of stay, treatment received

On work and relationships

Circumstances, context, injury sustained

Probation, jail time, fines

Medical issues may mimic psych problems

Especially chronic disease

May affect mood / limit psychiatric treatment

Psychiatric treatment, self-harm, suicide

Circumstances, patient's response, effect

Alcohol, marijuana, amphetamine, opioids, others

Period & pattern of abuse

Amount needed to reach the desired effect

What symptoms, severity

Level of success, length of abstinence

Time spent obtaining, using or recovering from

Physical / psychological

Regrets, extreme situations

Known complications

Milestones, neglect / abuse / trauma

Where, what level reached

And their consequences

Family, friends

Response to stress and adversity

Current and past jobs

Current and past relationships

Level of continued enjoyment