The Middle...

Once you have established all the details of the presenting complain you need to. Obtain all details of the patients past medical and past psychiatric history. This is the ideal time to screen for medical and psychiatric illness.

'How has your health been in the past?'

'Have you ever needed to see any doctor before this?'

'Have you ever been in hospital / had surgery / received treatment before?'

Now you need to get to know more about the patient as an individual. Find out about their personal history, family, social circumstances, forensic history and premorbid personality. Don't get the patient repeat information already established. At this stage it can be helpful to keep the patient engaged by sign posting.

You have told me about a great deal already now I want to understand more about how all this fits into your life...

'Can you tell me more about you and your life up till now…'

'Tell me specifically about your… childhood, schooling, adolescents, early adulthood... etc.'

'What experiences stick in your mind from your growing up?'

'What is family life like?'

'What's your current (financial, home, educational etc...) situation?'

'Have you ever done anything illegal… what happened?'

'Before all this (presenting complaint) started happening what kind of a person where you?'

If you build a good rapport and engage the patient most of the information will be volunteered easily. Some of the questions will bring up painful or embarrassing experiences from the patient life and are likely to cause emotional responses in the patient. If this happens recognise it an empathise with the patient have tissues handy. Always be ready to give the patient a break from the questioning, you may have to leave the interview for another session to find out everything you need.