 CHIEF COMPLAITS / CURRENT COMPLAINTS

 HISTORY OF PRESENT ILLNESS

 Duration-

 Mode of onset-[Graduate/sub-Acute/Acute]
 Intensity – [Same/Increasing/Decreasing]

 Triggering factors-

Associated Disturbances-
Treatment History
 Medication-

 Counselling/psychotherapy Taken?

History of Physical Illness-

Family Historty-

 Living Arrangement-

 Anyone with Same Problem-

SUBSTANCE HISTORY
 Do you take any kind of substance?[eg-
Alcohol,tobacco]

 Have you taken in the past?

 Has the dose /type remained same or

there was increase or decrease?
 Have you tired quitting?Were you
Successful?
 If not,what made you start?
 Name/Type of Substance?
 Quanity[Per day/Per week]
 Time of onset
 Trrigering factors
 Current Social Situation
 Can you talk About Your Home
Situation and relationship with
Parents/In Laws/Spouse/Children/
Siblings/Relatives/Colleagues?
 Can you Talk About Current Financial
Situation.[Stable/Not Stable]
 Are There Are Any Family Members
/Friends you can share your problem
with?

Personal History
 Pre Natal History-
 Birth History-
 Childhood History-
 Development Milestones-
School Education History-
Adolescent History-
 Running Away From Home.
 Smoking/Drug Use
 Relationship
 Delinquency

Occupational History-
Sexual /Marital History-

Premorbid Personality-
Personality
Predominant Mood
Attitude Towards self and
others
Attitude Towards work and
Responsibilities
Religious /Sipurtual Beliefs
Fantasy/Day dreaming.