Volume 12 Issues 12 December, 2022
As a third year medical student, this was my second time being posted in the psychiatry department after my second year two week posting period. I still remember how I used to be reluctant to attend my psychiatry postings as I assumed it was easy(Oh boy I was wrong) cause psychiatry wasn’t a part of our prof exam curriculum, after taking history for the first time it was very complicated as we couldn’t build rapport with the patient. The patient was diagnosed with schizophrenia, being a schizophrenic with the delusion of persecution, the patient thought we all had conspired against him and that he was normal. We couldn’t even get our sociodemographic data right, later our prof asked one of us to present, we had nothing, we told him what all had happened, the professor told “excellent”, we were wondering why though, later we realised that we had collected too much information even without our knowing just that it wasn’t in an ordered way.
Then we were briefed about proper history taking,
which information should come first, what to be included what not to be included, and where. From that day psychiatry has ever been challenging as well as interesting for all of us. In this article I would like to bring up the DO’s and DONT’s of history taking, based upon the mistakes that we did in our previous postings.
DONT’s
- Do not make assumptions
- Do not make unnecessary gestures in front of the patients or attenders
- Do not use words like “abnormal”, or any implicating words
- Do not hold your judgement or sociocultural beliefs when you are taking history
- Do not ask irrelevant questions
- Da nat repeat the questions you already gat the answer to unless its important
- Do not use your mobile phones to see the pro forma and question your patient
- Do not make a comment in front of the patient or attender
- Do not touch the patient’s belongings without seeking permission
- Do not read the case history before taking history You will find yourself asking leading questions to get your history right rather than actually taking it)
DO’s
- Be empathetic
- Try to build a good rapport
- Always use a non-judgemental tone
- Corroborate your history with the attender if it’s a reliable source
- Follow a pro forma
- Read the pro forma and memorise it and go to the patient
I hope this helps my juniors who are entering their clinical psychiatry pasting as I had wished someone had told me this before. Also do read GLIMPSES OF PSYCHIATRY for doctors and medical students, it will help you a lot .Here is a link:
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very nice