Guide for History Taking/ Anamnesis

I. Informant
1. Name
2. Address
3. Relationship to Patient
4. Length of time known to patient
5. Apparent understanding of present illness of the patient
6. Other characteristics and attitude of the informant

II. Family History

1. Maternal and Paternal Grand Lineages
1.1. History of nervousness and mental diseases, alcoholism, delinquency,
drug addiction, suicide, hereditary, dependency, chronic
unemployment, and other traits of inefficiency.
1.2. Has any of them to take care of the patient and how long. Mention also
the reason why and how this grand relative take care of the patient.
2. Father
2.1. What kind of man is the father? Give his salient personality traits. Give
his routine family discipline and personal philosophy about husband
and wife relationship and upbringing of children.
2.2. What are his social and financial status, his education, and his
experiences? What are his achievements and failures that might have
influenced the family life especially those of his children’s personalities,
or that of the patient’s illness? (Under failures, note vandalism, prolong
illness, unemployment, vagabondage, imprisonment, nervous and
emotional disease.)
2.3. If dead, was his death premature, and to have caused financial
difficulty or rupture of family ties. What are the consequences of the
patient?
2.4. What are his habits (both natural or acquired, note alcoholism, drug
addiction, etc.)
2.5. Does he gamble, sacrificing the welfare of the family? Is he sexually
pervert as to sacrifice family finance for women of ill-refute or other
women?
3. Mother
3.1. What kind of woman is the mother?
3.2. Is she working to supplement the family budget, entrusting her care of
the children to relatives or the neighbors?
3.3. Methods of disciplining children.
3.4. How is her relationship with her husband and other members of the
household?
4. Siblings
4.1. The number of brothers and sisters.
4.2. Influences of the siblings on the parents.
4.3. Cause of death and age of siblings. Any miscarriage or abortions.
 4.4. Relationship of siblings towards each other and other members of the
households.
4.5. History of delinquency, anti-social behaviors, or special personality
traits.

III. PERSONALITY HISTORY

1. Prenatal
1.1. The attitude of the mother towards this pregnancy
1.2. Did she has adequate obstetrical supervision
1.3. Well-nourished
1.4. Describe the mother’s emotion during the entire pregnancy which
might have influenced the growing fetus
2. Birth
2.1. Full-term or premature and date of birth
2.2. Unusual incidents attending the birth
2.3. a) Difficulty of labor
b) Instrumental sequels
2.4. Place – home or hospital
2.5. Attended by whom
3. Infancy and Childhood Characteristics
3.1. Breast or bottle feed
a) Describe feeding habit
b) Cuddling every feeding time
c) Describe how weaning was implemented
3.2. Was left under the care of the mother or the “Yaya”
3.3. Age of teething, talking and walking
3.4. When and how the subject toilet trained
3.5. Note history of enuresis, thumb-sucking, night terrors, tantrums,
stammering, history of falls, infantile convulsions, and other childhood
diseases, include duration and how it started.
4. Psychosexual History
4.1. Age of sex awareness
4.2. Masturbatory practices observed. Note the frequency and reactions of
both subjects and parents.
4.3. Age of menstruation – note regularity of period and reactions
4.4. In male – the age when voice lowered in pitch, the appearance of
seminal secretions. Age of circumcision.
5. Play Life
5.1. What game played or preferred
5.2. Plays with those of his sex or opposite sex
5.3. Plays with older or younger children
5.4. Leader or a follower in the game
5.5. Plays near or far from home or neighborhood
5.6. Any influence of sequel in habit-formation brought about by the
particular games or particular playmates
5.7. Does he abandon home or school work for the sake of playing?
6. School History
6.1. Age of entering school
6.2. Age of leaving school
6.3. Grade completed
6.4. Attitude toward school
6.5. Any school maladjustment – reasons for maladjustments.
6.6. Relations with teachers
6.7. Attendance – regular or irregular
6.8. Time spent on homework or lessons
6.9. Interest in studies
6.10. Does he pass every year or every semester?
6.11. His grades or marks obtained
6.12. Special liking to different subjects
7. Religious and Social Adaptability
7.1. Number of friends, their ages, sex, social levels, and character
7.2. Social attitudes and characteristics (friendly, shy, superior, jealous,
cruel, stubborn, moody, irritable, oversensitive, self-assertive,
submissive, choosy, daydreamer, seclusive, selfish, conceited, and
other peculiar habits)
7.3. Degree of religious interests and involvement
7.4. Reactions towards failure and success
8. Occupational History
8.1. Present occupation
8.2. Kind of work undertaken or job hold
8.3. Length of time of different undertakings or in different jobs
8.4. Reasons for changes in jobs
8.5. Salaries and savings
8.6. Attitude towards work with superiors and subordinates
8.7. Measures employed to increase production
9. Marital History
9.1. Love affairs and disappointments
9.2. Circumstances of marriage
9.3. The attitude of each toward sex relations and degree of sex
satisfaction
9.4. Age of marriage
9.5. Moderate or excessive sexual desires
9.6. The synchronicity of climax during coitus
9.7. Perverted or overt sexual practice – abnormal method of gratification
with same or opposite sex
9.8. Miscarriage or abortions, sterility
9.9. Refusal of partners sexual intercourse
9.10. Birth control measures
9.11. The infidelity of either one
9.12. Reasons for divorce or separation
9.13. Any nervous symptoms before, during or after menstruation
9.14. Climacteric (menopause)
 - Age when menstruation stopped or begin to be irregular, nervous
symptoms during the period
10. The onset of Present Illness
10.1. What incident precipitated the subject’s present condition?
10.2. Describe the symptoms manifested by the subject which prompted the
relative to sought hospitalization. (Note: Any referral to quack doctor)