The Psychiatric History:1. Identifying information: Socio-demographic summary Name Age Marital status Living arrangements Occupation or how do they support themself? Voluntary or involuntary patient2. History of Presenting Complaint: Symptoms Onset Duration/course Precipitants Exaggerating/alleviating factors Impact of illness of patients social, occupational, financial functioning Note current and previous treatment (dose and duration) 3. Psychiatric review of systems: Depression: Mood Energy or psychomotor disturbance Interest or enjoyment Motivation Appetite/weight change Sleep disturbance Hopeless/helpless themes and guilt Indecisiveness or poor concentration Suicidal ideation Mania: (now or in the past) Particularly happy or elevated Decreased need for sleep Grandiosity Pressured speech, flight of ideas or racing thoughts Distractibility Increase in goal-directed activity or psychomotor agitation Excessive involvement in pleasurable activity with high potential for painful consequences Psychosis: Ideas of reference: t.v. or radio talking specifically about you? Hallucinations: hear voices when no-one is around? Paranoia: Feel like people are taking particular notice of you? Feel that someone might want to hurt you? Difficulty concentrating Negative symptoms: lack of motivation, low mood etc Anxiety: Feel worried or nervous about everyday things or going out in public places? Heart racing, shortness of breath, sweaty etc Particularly concerned about a particular thing or things (OCD)4. Medical History Current and past medical conditions Current and past treatment 5. Personal history of psychiatric disorders and treatment: Details of previous episodes of illness Previous psychiatric admissions/treatment Outpatient/community treatment Suicide attempts/drug and alcohol abuse Interval function (what is the patient like between episodes when well) 6. Family history of psychiatric disorders and treatment7. Personal history: Prenatal/birth history Childhood Adolescence Adulthood: Educational Occupational Interpersonal/social Sexual Drug and alcohol use Marital history Children Leisure Forensic history

The Mental State Examination:1. General appearance and behaviour:2. Speech:3. Affect and mood:a. Qualityb. Rangec. Appropriatenessd. Assessment of suicidality 4. Thought:a. Streamb. Formc. Content (obsessions/delusions) 5. Perceptiona. Hallucinations/illusionsb. Depersonalisationc. Derealisation 6. Cognitiona. Level of consciousnessb. Orientationc. Concentrationd. Memorye. Intelligence Note: can just say not formerly assessed 7. Judgement8. Insight9. Rapport OSCE Stations:1. You are a registrar working at a general psychiatric ward assessing a new patient in the clinic. He is a 21 year old man who has a 2 month history of social withdrawal, problems with sleep and concentration and a decline in his academic functioning. There is also a history of personal decline. You have taken a history and have reached the point in the mental state examination where you need to elicit perceptual abnormalities.

2. Mr Da Silva, a 19 year old man with a 3 month history of social withdrawal has been referred to you by his GP. His parents have noticed that there has been a gradual decline in him socialising and he is more or less confined to his room. They have noticed that he is paranoid at times. You have taken a brief history and have reached the stage in the mental state examination where you need to elicit any abnormalities in his thinking.