HISTORY

TAKING -
ALCOHOL DEPENDENCE SYNDROME

KEERTHANA BABU
ALCOHOL DEPENDENCE

Drug dependence: It is a compulsion to take a drug

to produce a desired effect or to prevent
unpleasant effect when the drug is withheld.
Alcohol causes both psychological and physical
dependence.
HISTORY TAKING

CONTEXT OF THE INTERVIEW

Patient factors
Factors in the physical environment

COLLATERAL HISTORY
ORDER 1. Identifying data
2. Source and reliability
3. Chief complaint
4. History of presenting illness
5. Past psychiatric history
6. Substance use,abuse and addictions
7. Past medical history
8. Family history
9. Developmental and social history
10. Review of systems
11. Mental status examination
12. Physical examination
13. Formulation
14. Treatment planning
PERSONAL HISTORY

Childhood
Schooling
Occupation
Psychosexual history including relationships and marriage
Reproductive history
Children
Present social circumstances
Social support
Forensic history
TAKING A FULL DRINKING HISTORY

Ask about a typical drinking day or week.Go through the day

ascertaining type,quantity and context of alcohol intake.
After establishing current drinking level and problems, ask
about lifetime history of drinking such as when the patient
started drinking, pattern over the years, episodes of
dependent drinking, previous attempts to abstain and
previous treatment for alcohol problems.
UNITS OF ALCOHOL

1 unit contains 10 g of pure

alcohol.
It is equal to half a pint of
beer,one small glass of table
wine.
High risk of social/health
problems- men >50units/week.
women>35units/week.
FEATURES SUGGESTING ALCOHOL MISUSE

Alcohol consumption associated

with social,psychological and
physical problems constitutes
misuse.
FEATURES OF ALCOHOL DEPENDENCE
THE CAGE QUESTIONNAIRE
MENTAL STATUS EXAMINATION

Appearance and behaviour

Speech
Mood
Thought
Perception
Cognitive assessment
Insight
APPEARANCE AND BEHAVIOUR

We look into the dressing and general presentation.

To characterise socially appropriate behaviour following are
assessed:
1. General demeanour
2. Rapport
3. Eye contact
4. Gait
5. Reduced or increased motor activity
SPEECH PERCEPTION
Rate Abnormal perception
Structure

MOOD COGNITION
Subjective Orientation
Objective Registration
Attention and calculation
THOUGHT Recall
Form Language
Content
INSIGHT

Present - the patient is aware of having a mental illness

Absent - the patient has no awareness of illness

THANK
YOU