Pharmacology

The History, Mental State Examination and

Formulation

• HISTORY

➝Good Hx taking and examination

• Component
➝Age
➝Marital Status
➝Occupation

• Source of Referral
➝PC/HPC
➝PPH
➝PMH/PSH
➝FH MENTAL STATE EXAMINATION
➝PH (Personal history) ➝Appearance and behaviour
➝Smoke
➝Drink ➝Speech
➝Drugs
➝Mood
➝Allergies
➝Social Circumstances ➝Thought
➝Forensic history
➝PMP (Premorbid ➝Perception
➝Personality ➝Cognition

➝Insight

De-Andrie Gotuato PT21

 FORMULATION

➝Introduction

➝Current mental state

➝Diagnosis

➝Differential diagnosis

➝Investigations

➝Management

➝Prognosis

De-Andrie Gotuato PT21

 PSYCHIATRY

➝The medical science and specialty that deals How to Start Psychiatry
with the origins, diagnosis, prevention and
1. Psychiatric Interview
treatment of mental and emotional disorders
• Two Main Functions:
and, by extension, of many problems or
personal adjustment ➝It forms the main part of the psychiatric
assessment by which diagnoses are made.

• Psychiatric Disorders ➝It can be used therapeutically – in the

psychotherapies, the communication between
➝Illnesses that are conventionally treated with patient and therapist is the currency of
treatments used by psychiatrists treatment

➝Manifest with disordered psychological

functioning (emotion, perception, thinking and
2. Psychiatric A:
memory) or those that have no clearly
• Goals
established biological basis
➝To elicit the information needed to make a
➝Associated with abnormalities of the brain,
diagnosis
just as so-called medical disorders are
profoundly affected by psychological factors ➝To understand the causes and context of

the disorder.
• Where is Psychiatry going? ➝To form a therapeutic relationship with
➝Less hospital based the patient
➝Becoming more evidence-based.

➝More neuroscience based • BASIC PSYCHIATRIC ASSESSMENT:

➝used to collect the essential diagnostic and

contextual information.
• Why study psychiatry?
• DIAGNOSIS-SPECIFIC ASSESSMENTS:
➝A basic knowledge of the common and the
‘classic’ psychiatric disorders. ➝used if anything has led you to hypothesize
that the patient has a particular disorder.
➝A working knowledge of psychiatric
problems encountered in all medical settings.

➝The ability to eff ectively assess someone

with a ‘psychiatric problem’.

➝Skills in the assessment of psychological

aspects of medical conditions.

➝A holistic or ‘biopsychosocial’ perspective

from which to understand all illness

➝Useful knowledge

➝Useful skills
De-Andrie Gotuato PT21
➝Useful attitudes
 3. Diagnostic Categories

After the assessment: summarizing and

communicating the information

➝Make a (differential) diagnosis, according to

ICD 10 categories, using your knowledge of the
key features of each psychiatric disorder.

➝Attempt to understand how and why the

disorder has arisen.

➝Develop a management plan, based on an

awareness of the best available treatment, how
psychiatric services are organized and the
patient’s characteristics, including their risk of
harm to self or others

➝Communicate your understanding of the case

De-Andrie Gotuato PT2