Psychiatric Interview: Conclusion
The purpose of the psychiatric interview is to obtain information from the patient about the presenting problem and its precipitation and about previous disorders, predisposition, biopsychosocial strengths and limitations, reason for the current presentation, insight, and desire for help. The psychiatric history covers topics that range from identifying data to coping mechanisms. The four stages of the interview—inception, reconnaissance, detailed inquiry, and termination-are adapted to different topics.
In the inception stage, the interviewer makes introductions, gets the patient or family seated, takes identifying information, and summarizes what he knows. The quality of the interview is enhanced if the interviewer creates an atmosphere of trust, spontaneity, and expressiveness by his or her acceptance, empathic understanding, open-ended style, and natural manner. The decor, lighting, furnishings, and arrangement of the room can also promote (or subvert) the desired atmosphere.
During the reconnaissance stage, the interviewer helps the patient describe the presenting problem and its precipitation and development.
During the detailed inquiry, routine and discretionary, the interviewer explores past illness; early development and environment; later educational, occupational, social, and marital history; interests, values, and aspirations; habitual coping style; family history; and mental status.
During the interview, the clinician fosters free expression and association by being attentive and by using certain techniques such as vocal and nonvocal encouragement, support and reassurance, reflection of ideas or feelings, indication of inconsistencies, and paraphrasing.
The clinician will seldom, if ever, need to turn over every stone and pebble in this chapter. What is required is a set of criteria to decide whether comprehensive or brief discretionary screening MSE is indicated.
At termination, the interviewer summarizes the interview and negotiates with the patient over what the next step should be.
Colby KM: A Primer for Psychotherapists. Ronald Press, 1951.
McKinnon RA, Michaels R: The Psychiatric Interview in Clinical Practice. WB Saunders, 1971.
Nicholi AM: The Harvard Guide to Modern Psychiatry. Belknap Press of Harvard University Press, 1978.
Scheiber SC: The psychiatric interview, psychiatric history, and mental status examination. Pages 187-220 in: Hales RA, Yudofsky SC, Talbott JA (editors): The American Psychiatric Press Textbook of Psychiatry, 2nd ed. American Psychiatric Press, 1994.
Siegman AW: Review of interview research. Pages 481-530 in: Balis et al (editors): The Behavioral and Social Sciences and the Practice of Medicine. Butterworth, 1978.
Strauss G: The psychiatric interview, history, and mental status examination. Pages 521-530 in: Kaplan HI, Sadock BJ (editors): Comprehensive Textbook of Psychiatry, 6th ed. Williams & Wilkins, 1995.
Strub RL, Black FW: The Mental Status Examination in Neurology. FA Davis, 1993.
Rosse RB, Deutsch LH, Deutsch SI: Medical assessment and laboratory testing in psychiatry. Pages 601-618 in: Kaplan HI, Sadock BJ (editors): Comprehensive Textbook of Psychiatry, 6th ed. Williams & Wilkins, 1995.