Introduction to Psychiatry�History Taking & MSE.pptx

Introduction to Psychiatry�History Taking & MSE

1. Introduction to Psychiatry History Taking & MSE Dr. Mostafa Mahmoud Alsabban Lecturer of Psychiatry Al Azhar University- Damietta

2. OUR TASKS

3. Introduction To Psychiatry Key components of the History Taking in Psychiatry Master the Mental Status Examination (MSE) with practical examples.

4. Introduction Medical Branch Brief History Classification Systems (ICD/DSM)

5. Brief History of Psychiatry Middle Ages/ Islamic Civilization 17th-18th centuries 19th century Ancient times supernatural causes Trephination Hippocrates & the 4 Humors theory Continued belief in demonic possession. Development of “ Bimaristans " (hospitals) with specialized psychiatric wards Emergence of asylums for the mentally ill. Began shift towards viewing mental illness as medical condition 1808: Johann Christian Reil coins term "psychiatry“ Rise of moral treatment approach (e.g., Pinel in France) 1883: Emil Kraepelin introduces modern classification of mental disorders

6. Mid-20th century Late 20th century 21st century Early 20th century 1900s: Freud develops psychoanalysis. 1930s: Introduction of electroconvulsive therapy (ECT). 1950s: Discovery of first antipsychotic medications. 1952: First publication of DSM (Diagnostic and Statistical Manual of Mental Disorders). Deinstitutionalization movement begins. 1970s-80s: Development of SSRIs and other modern psychopharmacological treatments. Increased focus on neuroscience and biological basis of mental illness. Growing emphasis on integrated care and personalized medicine. Advancements in neuroimaging and genetic research. Increased awareness of mental health issues and efforts to reduce stigma.

7. Psychiatric Interview

8. Process of Psychiatric Interview Before During After

9. Before Psychiatric Interview Setting General Principles Out- patient In- patient ER Introduce yourself Rapport & Empathy Respect and Consideration Privacy and Confidentiality

10. During Psychiatric Interview History Taking Examination

11. History Taking Identifying Data Complain Past History History of Present Illness Source of Referral Personal History Family History

12. Identifying data N ame A ge S ex (Gender) O ccupation M arital Status R esidence R eligion Special H abits of medical importance H andedness. Graduated from With …………. Offspring Example: Mrs. Mona Ahmed Ali 22yrs old, Muslim, illiterate, from Cairo, housewife, married and has no children, lives in her father's house without special habits of medical importance.

13. Source of Referral “Mrs. Mona was referred to the Psychiatric outpatient yesterday by her family because of hers bizarre behavior”

14. Complaint= The most distressing symptom. “What bring you here today?” إيه أكتر حاجة جابتك المستشفى ليه قررت تكشف النهاردة Complaint from the patient: Own words native language Complaint from the informant : Reliable Chief Complain “ Mrs Lobna complains firstly of ‘low mood’, ‘difficulty sleeping”

15. History of Present illness The backbone of psychiatric case work up Horizontal vs Longitudinal Dimension comprehensive chronological

16. History of the present illness Onset: Acute, Gradual/Insidious. Course: Episodic, progressive, regressive, stationary/Continuous. Duration. Stressors هل اتعرضت لأي ضغوط أو مشاكل قبل المشكلة دي ممكن توصف لي الموضوع بدأ ازاي آخر مرة كنت كويس فيها متى الأعراض دي مستمرة زي ما هي ولا بتزيد ولا بتقل

17. The  Kupfer  Curve

18. History of the present illness Chronological. Stressors (The condition started 12 years ago. 2 days after the patient proposed to a girl and her family refused) . Description of the symptoms. Don’t mention psychiatric terms Exploration of related symptoms Psychiatric or medical services Medications: Doses (scientific names), Response to treatment, Compliance, Stoppage of treatment (when, why) Deficit. Functioning (Biological, social , occupational) Important Negatives eg. Suicide/ Homicide……Manic / Hypomanic Episodes….Hospitalization

19. History of the present illness