Page 1166 - TNFlipTest

PS2 Psychiatry Acronyms
5-HT serotonin
ACh acetylcholine
ACT assertive community treatment ADHD attention deficit hyperactivity disorder AN anorexia nervosa
ASD autism spectrum disorder
ASPD antisocial personality disorder
BN bulimia nervosa
CBT cognitive behavioural therapy
CD conduct disorder
CRA community reinforcement approach CT cognitive therapy
CTO community treatment order
DA dopamine
DBT dialectical behavioural therapy
DZ dizygotic
Screening Questions for Major Psychiatric Disorders
• Have you been feeling down, depressed or
hopeless?
• Do you feel anxious or worry about things?
• Has there been a time in your life where
you have felt euphoric, extremely talkative, had a lot of energy, and a decreased need for sleep?
• Do you see or hear things that you think other people cannot?
• Have you ever thought of harming yourself or committing suicide?
Psychiatric Functional Inquiry
MOAPS
Mood
Organic (e.g. substances and organic disease) Anxiety
Psychosis
Safety
Acronyms
Toronto Notes 2019
ECT electroconvulsive therapy MET EPS extrapyramidal symptoms MSE ERP exposure with response prevention MST EtOH ethanol/alcohol MZ GAD generalized anxiety disorder NA GMC general medical condition NMS IPT interpersonal therapy NOS MAOI monoamine oxidase inhibitor OCD MDD major depressive disorder OCPD MDE major depressive episode ODD
motivational enhancement therapy PD mental status examination PDD magnetic stimulation therapy PTSD monozygotic rTMS Narcotics Anonymous SGA neuroleptic malignant syndrome SNRI not otherwise specified SS obsessive-compulsive disorder SSRI obsessive-compulsive personality disorder TCA oppositional defiant disorder TD
personality disorder
pervasive developmental disorder post-traumatic stress disorder
repetitive transcranial magnetic stimulation second generation antipsychotics
serotonin and norepinephrine reuptake inhibitors serotonin syndrome
selective serotonin reuptake inhibitor
tricyclic antidepressant
tardive dyskinesia
• adjunct:makeupofhousehold,education,ethnicity,nationality,immigrationhistory(ifapplicable), religion, referral source, known or unknown to treatment team
• indicateif,andforwhatcontent;utilizecollateralsource(e.g.parent,teacher,partner)ifpatientunable/ unwilling to be interviewed
Psychiatric Assessment
History
Identifying Data
• necessary:name,age,sex/gender,maritalstatus,occupation/sourceoffinancialsupport,place/typeof residency
Reliability of Patient as a Historian
Chief Complaint
• inpatient’sownwords,withdurationofsymptoms
History of Present Illness
• reasonforseekinghelp(thatday)andhopes/expectationsfortreatment,currentsymptoms(onset, duration, fluctuations, progression, and course), potential precipitants for current problem, stressors, supports, functional status, and relevant associated symptoms (pertinent positives and negatives)
• findoutwhetherpatienthasanyactivemedicalproblems,findoutmedicationuse,doses,andadherence
• consider impact of current problems on personal care and survival, family functioning, occupational
functioning, and broad social functioning
• safetyscreen:endangeringselforothers,dependentsathome(e.g.children,pets),abilitytodrivesafely,
ability to care for self (e.g. eating, hygiene, taking medications)
Psychiatric Functional Inquiry
• mood: depression, mania
• anxiety:worries,panicattacks,phobias,orsocialanxiety
• historyoftrauma
• obsessive-compulsive: obsessions, compulsions
• psychosis: hallucinations, delusions
• riskassessment:suicidalideation,plan,intent,andhistoryofattempts(seeSuicide,PS4) • organic:smoking,EtOH/druguseorwithdrawal,illness,dementia
• allpreviouspsychiatricdiagnoses,psychiatriccontacts,treatments(pharmacologicalandnon- pharmacological), and hospitalizations
Past Psychiatric History
• includepastsuicideattempts,substanceuse/abuse,andproblems/encounterswiththelegalsystem
Past Medical/Surgical History
• allmedical,surgical,neurological(e.g.headtrauma,seizures),andpsychosomaticillnesses • currentmedications,allergies
• anypastorcurrentpsychiatricillnessesandhospitalizations,suicide,andsubstanceabuse • ifrelevant:anypastmedicalorgeneticillness
• familymembers:ages,occupations,personalities
• relationships with parents/siblings/partner/friends
• prenatalandperinatalhistory(desiredvs.unwantedpregnancy,maternalandfetalhealth,domestic
Family Psychiatric/Medical History
Past Personal/Developmental History (as relevant)
Always Remember to Ask About Abuse
See Family Medicine, FM26
violence, maternal substance use and exposures, or complications of pregnancy/delivery)
• earlychildhoodtoage3(developmentalmilestones,activity/attentionlevel,familystability,or
attachment figures)
• middlechildhoodtoage11(schoolperformance,peerrelationships,behaviouralchallenges)
• latechildhoodtoadolescence(drugs/alcohol,legalproblems,peerandfamilyrelationships)
• historyofphysicalorsexualabuse
• adulthood(education,occupations,relationships)
• personalitybeforecurrentillness,orrecentchangesinpersonality
• psychosexualhistory(puberty,firstsexualencounter,romanticrelationships,genderroles,andsexual
dysfunction)