History Taking And Mental State Examination

This book is initially attractive because of its succinct approach to the
psychiatric interview. However, it is because of its brevity that it does not
do the subject adequate justice. One of the book's aims is to offer practical
advice to clinicians conducting diagnostic interviews; particularly how to
phrase difficult questions. It is a personal matter as to what one considers
are difficult areas to explore, but the book does not really achieve this aim.
However, some of its descriptive definitions of key phenomenological terms are
beautifully illustrated by examples from patients. These illustrations
certainly bring the subject alive and arouse one's interest.
The book consists of a chapter on the history and a separate chapter for
each of the sub-sections of the mental state, with supplementary chapters on
intelligence, rapport and tests of cognition. This structure is basic and
familiar to clinicians but commentary on the order is lacking. The
introductory chapter provides a brief overview of classification of mental
health disorders and the biopsychosocial model, but without detailing the
potential pitfalls and controversial issues.
It is perhaps the history chapter that caused most concern. For example,
the section on the history of the presenting complaint informs the reader that
the breadth of the history should be explored, but not what to target in order
to achieve this. The section on the sexual history is amusingly phrased and is
rather entertaining as a result. Unfortunately, however, it does not suggest
how to appropriately phrase questions that cover issues such as ‘has the
patient reproduced?’. The succinct approach presented in this book is
therefore probably more suitable for students of medicine, nursing and social
services rather than mental health professionals.
The chapters on the mental state examination vary in quality. Of particular
note, the chapter on thoughts is reasonably comprehensive and provides a good
starting point for this often difficult part of the mental state examination.
The chapter on rapport provides an interesting description but makes no
comment on how to engage the patient.
Subsequent editions of this book would benefit from more detail on
transcultural issues and differentiation between diagnoses, as well as the use
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