CMN 548 UNIT 1 STUDY GUIDE
PSYCH TEST 1
Component Purpose/Definition Key Points How this is helpful
Identifying The introduction (including clarifying how the pt Anxieties are reduced
Data prefers to be addressed), by early clarification of
Anxieties…page explaining the practice’s processes, the nature and purpose
945 answering initial questions and of the encounter and
Identifying agenda setting defining a mutual
data…pg 948 agenda before
embarking on the
interview
Chief Pt has chance to Pts own words Important in
Complaint express self and understanding the
Pg 949 needs for the problem from the
encounter patient perspective;
important starting
point
HX of Present Chronological Details about the nature, Helps to answer the
illness description of the frequency, severity, & pattern of question of why is the
p. 949 evolution of sxms sxms incl. exacerbating & patient presenting now
of the current alleviating factors. Stressful life at this time.
episode events, physical sxms, med Txs the pt used during
changes, substance use patterns the current episode are
provide clues to context of the reviewed w/ attention
presentation, primary DX, to response,
comorbid conditions that can adherence, & attitudes
influence tx choices. about the tx. The
common use of
alternative, and OTC
txs makes it imp. To
inquire
specifically about the
use of these
products.
Past Psychiatric Psych illness 1.Details of prior mental health Understanding the
HX prior to the contacts. *Sites/levels of care: details of past tx will
p. 949, 950 current school-based, primary care-based, lead to a better
presentation incl. outpt, emergency, inpatient, understanding of
nature of sxms, partial hospital, recovery which txs are viable
course, & tx. programs. * Nature of prior tx: alternatives and which
Details of past psychotherapy, meds, to avoid.
episodes, incl. age technologies (i.e. ECT) recovery-
of onset, context, based, alternative and
nature & duration complimentary * Adherence &
of episodes, dx response to tx. 2. Prior acts of self-
offered, tx applied harm, SI, aggression, violence
& its setting,
degree of
,response, tx
adherence, &
, attitudes toward
tx.
Substance May be the Start with a normalizing Helps to i.d.
Use/Abuse primary reason for statement to reduce problematic current
p. 950 a referral & often defensiveness & elicit a fuller hx. or past patterns of
is an imp. Tools: CAGE-AID pg 950 use.
Secondary AUDIT (alcohol use
problem. Can disorders
mimic or induce identification test). Note age of
psychiatric onset, pattern of use over time,
syndromes, current frequency level of use,
elevate risk of SI & consequences of use (physical,
violence, & have mental, social, legal). Also inquire
imp. Impact on about tobacco, & problem
safe med gambling. Also i.d. periods of
prescribing. Imp to abstinence & what helped pt
understand the achieve control incl. any
pts current & past specialized tx w/details about the
patterns of setting, nature of & response to tx,
substance use. & engagements w/peer support
such
as AA.
Past Medical Used to review Neuro and endocrine disorders are Helpful due to overlap
HX both past and of particular interest bc of the in s/s w/psych
present medical significant overlap in s/s with disorders. Females:
HX; an psych syndromes. Females: reproductive/menstrual
accounting of reproductive/menstrual HX & & pregnancy bc of
major medical potential for pregnancy. Current hormonal changes &
disorders to medications bc some can create threats to pregnancy of
develop a side effects that mimic psych some drugs. Some
complete HX & to disorders & to i.d. drug-drug meds w/side effects
i.d. illness that interactions. that mimic psych
could mimic a disorders. i.d. drug-
psych disorder, drug interactions.
contribute to
the context of
the
presentation, or
factor into tx
planning.
Family HX i.d. family Psych illness may have a genetic
p.951 members with HX component. Patients may not Can aid in DX & est.
of known or know exact family DX, but can give prognosis. Id’s
suspected mental s/s so that a reasonable hypothesis families with hx of
illness, substance can be made. Offers clues to known or suspected
abuse disorders & patient’s risk factors. mental illness,
other behavioral substance abuse,
problems behavior probs so
(criminality). that reasonable
Completed suicide hypotheses re DX can
raises risk index. be made
, Developmental Reviews the stages 1. Pg & delivery Imp. In 1st encounters
& Social HX of the pts life from 2. Dev. milestones to give patient’s a
P.951 gestation to the 3. Education (incl. sense that one ins
present w/an eye special needs, in- interested in their
toward school counseling, personhood & the
understanding the discipline problems contexts of their
imp. Exposures, 4. Occupation HX distress, not just their
relationships, & 5. Military S/S. Reviewing social
events that shaped 6. Legal HX chronologically
the persons life 7. Relationships/committed provides a natural flow
story. Helps in relationships to the questions &
understanding the 8. Parenting ensures a complete HX;
nature of the 9. Leisure
person’s 10. Traumatic or potentially
temperament & traumatic exposures (incl.
character & degree neglect, physical, &
to which the abuse).
person has May have to consult
achieved collateral historians to obtain
developmentally clear development & social
appropriate role HX.
fxns such as
academic progress,
work, peer,
romantic
relationships, &
parenting capacity.
Review of Captures any Sleep: sleep phase problems Helps capture any
Systems p current physical (initial, middle, terminal insomnia) current physical s/s not
952 s/s not already total sleep time, abnormal sleep already identified in HPI
identified in HPI or events. or past medical HX.
past medical HX. Mood: Depression or
Organized by hypomania/mania
major systems. Anxiety: panic attacks, somatic,
phobic, social avoidance
Psychosis: AVH, delusions,
disorganized behavior, speech
or thought, negative s/s
Obsessive-compulsive: Repetitive
intrusive & unwanted thoughts,
behaviors to neutralize anxiety,
hoarding behavior
Trauma: intrusive & avoidance
s/s, altered cognition/mood;
excess arousal/reactivity
Behavioral: Substance use,
gambling, impulse control
problems, disordered eating,
PSYCH TEST 1
Component Purpose/Definition Key Points How this is helpful
Identifying The introduction (including clarifying how the pt Anxieties are reduced
Data prefers to be addressed), by early clarification of
Anxieties…page explaining the practice’s processes, the nature and purpose
945 answering initial questions and of the encounter and
Identifying agenda setting defining a mutual
data…pg 948 agenda before
embarking on the
interview
Chief Pt has chance to Pts own words Important in
Complaint express self and understanding the
Pg 949 needs for the problem from the
encounter patient perspective;
important starting
point
HX of Present Chronological Details about the nature, Helps to answer the
illness description of the frequency, severity, & pattern of question of why is the
p. 949 evolution of sxms sxms incl. exacerbating & patient presenting now
of the current alleviating factors. Stressful life at this time.
episode events, physical sxms, med Txs the pt used during
changes, substance use patterns the current episode are
provide clues to context of the reviewed w/ attention
presentation, primary DX, to response,
comorbid conditions that can adherence, & attitudes
influence tx choices. about the tx. The
common use of
alternative, and OTC
txs makes it imp. To
inquire
specifically about the
use of these
products.
Past Psychiatric Psych illness 1.Details of prior mental health Understanding the
HX prior to the contacts. *Sites/levels of care: details of past tx will
p. 949, 950 current school-based, primary care-based, lead to a better
presentation incl. outpt, emergency, inpatient, understanding of
nature of sxms, partial hospital, recovery which txs are viable
course, & tx. programs. * Nature of prior tx: alternatives and which
Details of past psychotherapy, meds, to avoid.
episodes, incl. age technologies (i.e. ECT) recovery-
of onset, context, based, alternative and
nature & duration complimentary * Adherence &
of episodes, dx response to tx. 2. Prior acts of self-
offered, tx applied harm, SI, aggression, violence
& its setting,
degree of
,response, tx
adherence, &
, attitudes toward
tx.
Substance May be the Start with a normalizing Helps to i.d.
Use/Abuse primary reason for statement to reduce problematic current
p. 950 a referral & often defensiveness & elicit a fuller hx. or past patterns of
is an imp. Tools: CAGE-AID pg 950 use.
Secondary AUDIT (alcohol use
problem. Can disorders
mimic or induce identification test). Note age of
psychiatric onset, pattern of use over time,
syndromes, current frequency level of use,
elevate risk of SI & consequences of use (physical,
violence, & have mental, social, legal). Also inquire
imp. Impact on about tobacco, & problem
safe med gambling. Also i.d. periods of
prescribing. Imp to abstinence & what helped pt
understand the achieve control incl. any
pts current & past specialized tx w/details about the
patterns of setting, nature of & response to tx,
substance use. & engagements w/peer support
such
as AA.
Past Medical Used to review Neuro and endocrine disorders are Helpful due to overlap
HX both past and of particular interest bc of the in s/s w/psych
present medical significant overlap in s/s with disorders. Females:
HX; an psych syndromes. Females: reproductive/menstrual
accounting of reproductive/menstrual HX & & pregnancy bc of
major medical potential for pregnancy. Current hormonal changes &
disorders to medications bc some can create threats to pregnancy of
develop a side effects that mimic psych some drugs. Some
complete HX & to disorders & to i.d. drug-drug meds w/side effects
i.d. illness that interactions. that mimic psych
could mimic a disorders. i.d. drug-
psych disorder, drug interactions.
contribute to
the context of
the
presentation, or
factor into tx
planning.
Family HX i.d. family Psych illness may have a genetic
p.951 members with HX component. Patients may not Can aid in DX & est.
of known or know exact family DX, but can give prognosis. Id’s
suspected mental s/s so that a reasonable hypothesis families with hx of
illness, substance can be made. Offers clues to known or suspected
abuse disorders & patient’s risk factors. mental illness,
other behavioral substance abuse,
problems behavior probs so
(criminality). that reasonable
Completed suicide hypotheses re DX can
raises risk index. be made
, Developmental Reviews the stages 1. Pg & delivery Imp. In 1st encounters
& Social HX of the pts life from 2. Dev. milestones to give patient’s a
P.951 gestation to the 3. Education (incl. sense that one ins
present w/an eye special needs, in- interested in their
toward school counseling, personhood & the
understanding the discipline problems contexts of their
imp. Exposures, 4. Occupation HX distress, not just their
relationships, & 5. Military S/S. Reviewing social
events that shaped 6. Legal HX chronologically
the persons life 7. Relationships/committed provides a natural flow
story. Helps in relationships to the questions &
understanding the 8. Parenting ensures a complete HX;
nature of the 9. Leisure
person’s 10. Traumatic or potentially
temperament & traumatic exposures (incl.
character & degree neglect, physical, &
to which the abuse).
person has May have to consult
achieved collateral historians to obtain
developmentally clear development & social
appropriate role HX.
fxns such as
academic progress,
work, peer,
romantic
relationships, &
parenting capacity.
Review of Captures any Sleep: sleep phase problems Helps capture any
Systems p current physical (initial, middle, terminal insomnia) current physical s/s not
952 s/s not already total sleep time, abnormal sleep already identified in HPI
identified in HPI or events. or past medical HX.
past medical HX. Mood: Depression or
Organized by hypomania/mania
major systems. Anxiety: panic attacks, somatic,
phobic, social avoidance
Psychosis: AVH, delusions,
disorganized behavior, speech
or thought, negative s/s
Obsessive-compulsive: Repetitive
intrusive & unwanted thoughts,
behaviors to neutralize anxiety,
hoarding behavior
Trauma: intrusive & avoidance
s/s, altered cognition/mood;
excess arousal/reactivity
Behavioral: Substance use,
gambling, impulse control
problems, disordered eating,
