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Dr. Kapoor's Mental Health Intake Template 

 

Identifying Data:

Name

Age

Relationship/Marital status/length

Children/#/where/contact

Living situation

Employment/Training

Source of Income

Country of origin

 

Reason For Referral:

(Doctor’s words)

 

Chief Complaint:

Problem leading you to come here and duration

(Patient’s words)

 

History of Present Illness:

Time frame

Stressors

Symptoms

Coping strategies

Supports

Screen for Substance abuse

 

Screen for Mood

Depression (MSIGECAPS acronym from Toronto Notes)

Mania (GST PAID acronym from Toronto Notes) “ever find you have an extremely good mood for days, nothing can go wrong, feel on top of the world”

 

Screen for Anxiety

Panic Attacks (STUDENTS fear the 3Cs acronym from Toronto Notes)

GAD (BESKIM acronym from Toronto Notes)

OCD (“do you ever have excessive worries or thoughts that you go over and over for no reason, followed by acts/thoughts to feel better”?)

Phobias (fear of object or situation, “shy in social situations”?)

PTSD (“ have you ever had a traumatic experience that you still think about now? Ever relive any experiences?”)

 

Screen for Psychosis

Delusions (thought insertion and broadcasting)

Hallucinations –“ do you ever hear or see things that other people don’t”

Illusions

 

Screen SI/HI:

SADPERSONS (acronym from Toronto Notes), determine frequency, plan, intent, attempts

 

Past Psychiatric History:

Previous suicide attempts

Legal history

Hx of substance abuse (Nicotine, ETOH, Rx)

Admissions

 

Medical History:

R/O hx of HI, seizures, thyroid problem, frontal lobe injury, HIV, Syphilis

Hospitalizations

Sx

R/O B12/iron/folate deficiency

Check lytes and baseline cr/cbc/cholesterol/ECG for QTc

 

Medications:

Ask about caffeine and energy drinks

 

Allergies:

 

Personal History:

Developmental History: problems with pregnancy, developmental milestones, personality in school, friends in school, grades, high school, how old when you first started dating? Any history of abuse? Problems with the law?

School: Highest level of education

Relationships: current, past, longest

Occupational history: training, jobs, lengths

 

Family Psychiatric History:

Suicides

Substance abuse

 

Mental Status Exam

Appearance: age, groomed, walk

Behavior: movements, eye contact, cooperative

Speech: rate, volume, clear

Mood: what they say

Affect: quality, range, stable, appropriate, congruent

Thought Content: SI/HI, worries, delusions

Thought Process: coherence, logic, stream

Perception: hallucinations, illusions, depersonalization, derealization

Insight: into illness and treatment

Judgment:

Cognition:

 

Impression:

DSM-V Diagnosis

 

Patient Goals:

What are they hoping to achieve? Our expectations may be different from the patient’s

 

 

 

 

 

 

Diagnostic Pneumonics from TO Notes:

 

Mania: GST PAID
Grandiosity
Sleep - decreased
Talkative
Pleasurable activities - Painful consequences
Activity
Ideas - Flight of ideas
Distractibility

 

Depression: MSIGECAPS
Mood - depressed
Sleep - increased/decreased
Interest - decreased
Guilt
Energy - decreased
Concentration - decreased
Appetite - Increased/decreased
Psychomotor - agitation/retardation
Suicidal ideation

 

Panic Attacks: STUDENTS FEAR the 3 C's
Sweating
Trembling
Unsteadiness/dizziness
Depersonalization/Derealization
Excessive HR/palpitations
Nausea
Tingling
Shortness of breath
Fear of dying, loosing control, going crazy
3C: chest pain, chills, choking

 

Generalized Anxiety Disorder: BE SKIM
Blank mind
Easily fatigued
Sleep disturbance
Keyed up
Irritability
Muscle tension

 

Suicide Risk Factors: SAD PERSONS
Sex - male
Age > 60 years
Depression
Previous attempts
Ethanol abuse
Rationale thinking loss
Suicide in family
Organized plan
No spouse
Serious illness, intractable pain

 

 

 

 

 

 

 

 

 

~ Dugani, S. & Lam, D. (2009).Toronto Notes 2009. Toronto: Toronto Notes for Medical Students Inc.

 

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