Brief Summary
This video provides a guide on how to conduct an interval history in psychiatry. It outlines three main goals: updating the patient's mental status and symptoms, monitoring their response to treatment and any side effects, and collaboratively planning the next steps in their treatment. The video also introduces the "MASTERS" mnemonic (Mood, Appetite, Sleep, Treatment plan, Side effects, Treatment response, and Safety) as a tool to remember the key areas to cover during the interview.
- Gathering updates on the patient's mental status and current symptoms.
- Monitoring the patient's response to treatment and any side effects.
- Collaboratively determining the next steps in treatment.
Introduction to Interval History
An interval history, or follow-up history, captures information about a patient's condition since their last visit. The length of the interval varies depending on the treatment setting, ranging from daily updates in inpatient settings to monthly check-ins in outpatient care. Regardless of the interval length, the core principles of gathering this history remain consistent.
Goals of Interval History
The primary goals of an interval history are to update the patient's mental status and symptoms, assess their response to treatment and any side effects, and collaboratively determine the next steps in treatment. These goals provide a structured approach to gathering relevant information and guiding treatment decisions.
Updating Mental Status and Symptoms
This involves checking in on key indicators such as mood, appetite, sleep, and any safety concerns. The approach typically begins with open-ended questions to allow the patient to express what is most important to them. Specific questions about mood, appetite, sleep, and safety are then used to gather more focused information. Safety concerns include suicidal or homicidal thoughts, as well as active psychosis symptoms like hallucinations, which may necessitate emergency intervention.
Response to Treatment and Side Effects
The focus is on the patient's chief complaint, starting with open-ended questions about changes in symptoms since the last visit. Specific symptoms relevant to the diagnosis are then explored. Similarly, side effects are addressed by first asking open-ended questions about any noticed side effects, followed by specific inquiries about common side effects associated with the patient's medications.
Determining Next Steps in Treatment
This involves reviewing all current treatment modalities, including biological, psychological, and social treatments. Patient disposition, which refers to the next stage of treatment, is also addressed. Treatment planning can be approached by asking the patient what they want to do next, or by offering a recommendation and seeking their feedback. Shared decision-making is crucial, and the discussion should conclude with an opportunity for the patient to ask questions.
MASTERS Mnemonic and Practical Application
The "MASTERS" mnemonic (Mood, Appetite, Sleep, Treatment plan, Side effects, Treatment response, and Safety) serves as a helpful tool for remembering the key areas to cover during an interval history. Using a template with these topics listed can aid in efficiently recording patient responses in shorthand. Examples are provided to illustrate how this template can be used to document patient information and track treatment progress.
