Appendix 2: A GUIDE TO TAKING THE MAUDSLEY HISTORY

OPENING THE INTERVIEW

ƒ introduction
ƒ explain the purpose

PROFILE QUESTIONS

ƒ age
ƒ occupation
ƒ marital status
ƒ who the patient lives with
ƒ main source of income
ƒ type of residence
ƒ suburb / town
ƒ patient type
ƒ cultural assessment
ƒ other (eg. current people involved in their care)

PRESENTING COMPLAINT

History of Presenting Complaint

ƒ focus
ƒ phenomenology
ƒ time course
ƒ onset
ƒ frequency
ƒ fluctuations
ƒ precipitants

Vegetative Features

ƒ sleep
ƒ appetite
ƒ weight
ƒ energy
ƒ diurnal mood variation
ƒ libido
ƒ bowels
ƒ menstrual history

Psychomotor Disturbance

ƒ psychomotor retardation
ƒ psychomotor agitation
ƒ psychomotor acceleration

Symptom Review

Mood (note – this should be included prior to vegetative features if presenting

complaint includes a mood disturbance)
ƒ depression
ƒ mania

Anxiety
ƒ panic
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ƒ OCD
ƒ PTSD
ƒ Phobia (social or other specific)

Psychosis
ƒ hallucinations
ƒ passivity experiences
ƒ delusions

Eating Disorder
ƒ concerns
ƒ restricting
ƒ binge
ƒ compensation

Somatisation
ƒ somatic symptoms
ƒ hypochondriasis
ƒ dysmorphobic

Dangerousness

ƒ suicide
ƒ DSH
ƒ homicide
ƒ weapons

Precipitant / Stressors

ƒ stressors - family , work, finances

ƒ anniversary phenomena
ƒ life cycle phenomena

Disability

ƒ general
ƒ worst thing
ƒ relationships / roles / capacity for
ƒ activities the patient is unable to perform due to illness

Attribution

ƒ the patients wider sense of why they are unwell

Past Psychiatric History

Chronic Illness
ƒ onset
ƒ first diagnosed

In-patient
ƒ first admission / subsequent admission
ƒ compliance
ƒ inter-episode function

Out-patient
ƒ out-patient illness episodes
ƒ regular psychiatrist and case manager
ƒ relationship
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Undiagnosed Episodes

Past Medical / Surgical History

ƒ general
ƒ causes for psychosis / depression / mania / anxiety

Medications

ƒ medications
ƒ side effects
ƒ attitude
ƒ compliance

Allergies

Cigarettes

Alcohol

Illicit Drugs

ƒ cannabis
ƒ sedatives
ƒ amphetamines
ƒ hallucinogens
ƒ opioids
ƒ inhalants
ƒ dissociative anaesthetics
ƒ steroids

General Substance Inquiry

ƒ route
ƒ quantity
ƒ last use
ƒ reasons for use

Problems with use

ƒ abuse
ƒ dependence

Forensic

ƒ legal record
ƒ personal crime
ƒ property crime

Family History

Mother
ƒ profile
ƒ health
ƒ relationship
ƒ personality
ƒ death / grief

Father
ƒ profile
ƒ health
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ƒ relationship
ƒ personality
ƒ death / grief

Siblings

Other significant relatives

Family Psychiatric History

Personal History ( if time permits)

Perinatal
ƒ place of birth
ƒ pregnancy
planned
problems

Birth and Neonatal

ƒ maturity
ƒ delivery
ƒ neonatal

Childhood
ƒ general
ƒ milestones
ƒ temperament
ƒ health
physical
psychological

Externalising Internalising Other

ƒ trauma
ƒ childhood sexual abuse
ƒ separations
ƒ bereavement

Adolescence
ƒ general
ƒ rebellion
ƒ relationships
ƒ aspirations
ƒ puberty

Education

ƒ profile
ƒ academic
ƒ social
ƒ authority

Occupation

ƒ profile
ƒ achievement
ƒ satisfaction and problems
ƒ work injury
ƒ military service

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Relationships

ƒ profile
ƒ partner
ƒ relationship termination
ƒ death / grief

Sexual History

ƒ active
ƒ partners
ƒ problems
ƒ STD's

Pregnancy and Children

ƒ profile
ƒ children

Life Situation at Present

ƒ average day
ƒ assistance
ƒ plans for future

Pre - morbid Personality

ƒ attitudes to others
ƒ attitude to self
ƒ reaction to stress
ƒ mood
ƒ leisure
ƒ moral and religious standards

MENTAL STATE EXAMINATION

Appearance

ƒ grooming
ƒ attire

Behaviour

ƒ gait
ƒ posture
ƒ eye contact
ƒ gestures with speech

Conversation

ƒ form
rate, tone, accent
links between ideas (eg looseness of association, flight of ideas)
ƒ content
manifest - actual content
latent - underlying themes
delusions

Affect

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ƒ subjective - as reported by patient (mood)
ƒ objective - as evident to interviewer eg.
reactive - varies over time
blunted - dulled as in schizophrenia
elevated - as in mania
flat - as in depression

Perception

ƒ hallucinations
ƒ illusions

Cognition

ƒ orientation day, date, month, year, place

ƒ memory STM - address or 3 objects
LTM - general knowledge
ƒ attention serial 7's or 3's
ƒ thought or abstraction interpretation of a proverb

Insight

ƒ patients understanding or acceptance of their psychological illness

Intelligence

ƒ above average
ƒ average
ƒ below average

Rapport

ƒ quality of the relationship attained between the patient and interviewer eg.
deep - exceptionally good rapport
adequate
superficial
limited - poor rapport only achieved

EMOTIONAL RESPONSE TO THE PATIENT

The interviewer’s own emotional response to the patient is often significant value in
understanding and diagnosing the patient's condition. For example, interviewing a depressed
patient can make the interviewer feel emotionally flat by the end of the interview. Some
patients have their view of the interviewer coloured by their interactions with significant others
earlier in their lives (a process known as transference). For example, a patient who has been
controlled and dominated by a parent for most of their life may react to the interviewer as if
they are again going to be treated in this way. The interviewer may, in turn, react to the
patient's transference in a particular way. This is referred to as counter - transference.

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