Psychiatric Interview

A working diagnosis classifies the symptoms and signs (illness), the context (predicament), and where possible the pathophysiology (disease).A working diagnosis classifies the symptoms and signs (illness), the context (predicament), and where possible the pathophysiology (disease).
Hierarchy: physical conditions (hallmark confusion) before psychoses (hallmark impaired reality testing: delusions, hallucinations) before depression and anxiety (affective symptoms without confusion or impaired reality testing).Hierarchy: physical conditions (hallmark confusion) before psychoses (hallmark impaired reality testing: delusions, hallucinations) before depression and anxiety (affective symptoms without confusion or impaired reality testing).
Ask the patient's understanding of the reason for the interviewAsk the patient's understanding of the reason for the interview“What is your understanding of why we are meeting today?”

The reason the patient is here: current problems, the patient's and others' expectations.The reason the patient is here: current problems, the patient's and others' expectations.
Development and course, including prior psychiatric illness and treatment.Development and course, including prior psychiatric illness and treatment.
Severity: effect on day-to-day function at work and home (personal care, family, occupational and social functioning).Severity: effect on day-to-day function at work and home (personal care, family, occupational and social functioning).
Safety: impact on the patient's safety and the safety of others (risk assessment).Safety: impact on the patient's safety and the safety of others (risk assessment).
Causal factors: current personal and social circumstances (relationships, housing, occupation, finances, legal, interests, recent changes).Causal factors: current personal and social circumstances (relationships, housing, occupation, finances, legal, interests, recent changes).
Active physical factors: medical problems, medications, drug and alcohol use.Active physical factors: medical problems, medications, drug and alcohol use.
Systematic enquiry with the screening questions; personal and developmental history if time allows.Systematic enquiry with the screening questions; personal and developmental history if time allows.

How dangerous is the condition? Is anyone at risk of life, limb, or the necessities of life?How dangerous is the condition? Is anyone at risk of life, limb, or the necessities of life?
How great is the functional impairment? Basic and instrumental activities, work, self-support, dependents, family and community.How great is the functional impairment? Basic and instrumental activities, work, self-support, dependents, family and community.
What is the immediate psychosocial context, including loss or change?What is the immediate psychosocial context, including loss or change?
What physical factors are at play: concurrent illness, medications, drugs, alcohol?What physical factors are at play: concurrent illness, medications, drugs, alcohol?
Who is the person: intelligence, capacity for enduring reciprocal relationships, capacity for work and independence?Who is the person: intelligence, capacity for enduring reciprocal relationships, capacity for work and independence?

Write the mental status examination