interview questions for schizophrenia patient

When it comes to conducting an interview with a patient diagnosed with schizophrenia, it is essential to ask the right questions in order to gain a clear understanding of the individual’s mental health and current state of well-being. As such, it is important to research the types of questions that are best-suited to such an interview. In this blog post, we will explore a range of pertinent questions to be asked during an interview with a schizophrenia patient. These questions will help to uncover aspects of the patient’s life, such as their experience of symptoms, relationships, and daily functioning. Additionally, this post will also address the importance of being aware of the patient’s preferences, needs, and rights during the interview. By the end of the blog post, you will have the tools to effectively and compassionately engage in an interview with a schizophrenia patient.

• Have you ever heard voices/people talking about you when no-one else is around/you are on your own? ( …
• Where do they come from – from inside your head or through your ears?
• Do they talk directly to you or about you? ( …
• How often do you hear them?
• How do they affect you?

Psychiatric Interviews for Teaching: Psychosis

Encountering the patient for the first time

A person experiencing a first episode of psychosis may come to our attention in a variety of ways. The patient typically arrives not long after the initial signs and symptoms. Some patients, however, wait years before seeing a clinician. Such delays may be brought on by social and physical isolation from others, with or without profound negative symptoms that cause the person to essentially become a shut-in, or by a family bias against recognizing the symptoms as being a part of an illness. However, the majority seek medical attention within the first two years of the onset of their symptoms (1). The most frequent referrals come from family, friends, and teachers, but it’s not uncommon for patients to self-refer when they can recognize they have a problem and aren’t afraid to talk about their symptoms.

A complex set of questions and choices must be taken into account once the patient contacts a clinician, and a plan must be developed. Figure 1 outlines a sample decisional algorithm. Safety is a primary consideration. With patients who are openly evasive, guarded, or paranoid, the answer may not be obvious as to whether the patient poses a threat to himself or others. The doctor must ask the patient about any thoughts of harming themselves or others in a kind but direct manner. Asking patients who have children whether they feel the need to protect them, even if that means “taking them away from this world,” is crucial. “The patient will need to be hospitalized if there is a credible fear that they might hurt themselves or others while suffering from psychosis.” A mildly psychotic patient who expresses no such risky intentions may be able to receive treatment in an outpatient setting. When there are less restrictive alternatives available, forcing patients into hospitals can discourage them from receiving long-term care. Patients who are sent home following their initial visit are advised to follow up closely. In order to give the medication, which is typically an antipsychotic agent, time to take effect, we find that seeing them after a week is ideal. However, we inform patients and their families that if necessary, they can call ahead or visit our crisis center earlier.

A differential diagnosis must be developed at the first visit. It is important to identify and rule out all potential medical, toxic, and substance-related causes of psychosis (Table 1). It is essential to have a valid working diagnosis when creating a suitable treatment strategy. For instance, if systemic lupus erythematosus is the cause of a psychosis, both the psychosis and the autoimmune condition must be treated. A working diagnosis is based on the evidence at hand and is updated as new information is gathered, but it is not always the final or conclusive diagnosis.

Last but not least, the patient’s family must be treated specially during the initial encounter. A crude diagnosis and prognosis announcement can befuddle or even destroy the family. The patient’s treatment as well as the family’s treatment may begin with the initial encounter.

There is no “best” way to conduct the initial interview with a patient who is experiencing their first episode, and skilled clinicians use a variety of methods and approaches. Understanding that the symptoms, diagnosis, prognosis, and treatment can all be extremely frightening for patients and their families is what all successful styles have in common. The extent of the issue may become apparent right away or may become apparent over the course of the interview and subsequent treatment. The patient and family may not have any prior knowledge of or references for the presentation, in contrast to the experienced clinician who has seen it before. However, it’s interesting to note that as mental illnesses, particularly depression, anxiety, and schizophrenia, are increasingly made public through the media, the general public is learning more about them. One patient, for instance, who initially presented with severe paranoid delusions, said, “My husband thinks I might be like that Beautiful Mind guy.” ”.

Sometimes a patient presents alone, in which case only the patient participates in the face-to-face interview. Patients are more frequently accompanied by, or brought in by, friends or family. All participants should be included in the interview, both collectively and individually. Assuring the patient’s safety comes first in cases where an interview is impossible, and the clinician must rely on the family to provide the necessary information. Asking the patient whether they would feel more at ease speaking with the family present or speaking alone, if possible, engages the patient and gives them a sense of respect and autonomy. The patient and family should each get a chance to speak privately with the clinician at some point. Families frequently offer a wealth of knowledge regarding the onset and progression of the illness. They are able to provide details about the patient’s personality and prior functioning, which are crucial for the differential diagnosis. Of course, patient privacy must be protected, as it always is during doctor-patient interactions. When the family wants to inform the patient but expresses a strong desire to keep this information from them, it can be difficult. We inform the patient’s family that we will have to present the patient with any information required to determine whether the patient needs to be involuntarily committed. A good rule of thumb is to advise families not to share any private information that could compromise the doctor-patient relationship.

Like in any effective interview, the clinician should start with open-ended inquiries before moving on to more formal and direct inquiries as necessary. Be aware that, if the patient’s family is present, it may be the first time they hear the patient describe his or her symptoms, and this could come as a surprise to them. Ask patients if they feel safe in the room or if they are uncomfortable having family members or other clinicians in the room when they are reluctant to speak for whatever reason. Leading questions can frequently assist in starting the patient. “I know this might be a scary time for you, but I often hear from people who come here that they are hearing strange voices in their heads,” for instance It can be reassuring to the patient to learn that psychotic symptoms are not uncommon and that you have treated others with comparable issues.

The majority of patients and their families prefer a specific diagnosis at the initial consultation. We explain that any medical diagnosis necessitates a thorough collection of information and is best done longitudinally rather than cross-sectionally and that we believe a diagnosis at that time would be premature. In this interview, we don’t even bring up schizophrenia; instead, we concentrate on the signs, protection, and care. An exception might apply in situations where there is a family history of schizophrenia and other family members have displayed symptoms similar to it. The patient or family may have determined the diagnosis on their own and are requesting the psychiatrist’s confirmation.

In the brief psychiatric interview

Research evidence and clinical expertise serve as the evidence base for this article’s author, Jon Davine. Copyright Date Created: 2015-12-09 Date Reviewed: 2017-06-12

Subspecialty See also:

The interview and assessment will differ greatly when evaluating a child, adolescent, or older adult. See the pages above.

To frame the interview and comprehend your patient’s social situation, ask the pertinent social history up front.

The Psychiatric Review of Systems

“Now, I’m going to ask you about some additional signs of depression people might experience.” ”: See main article:

FAQ

What questions should I ask a schizophrenic patient?

Have you recently had any strange or unusual experiences that you cannot explain? “Do you ever hear things that other people cannot hear, such as noises or the voices of other people whispering or talking?” are two quick screening questions for psychotic symptoms.

How do you interview a schizophrenic patient?

Like in any effective interview, the clinician should start with open-ended inquiries before moving on to more formal and direct inquiries as necessary. Be aware that, if the patient’s family is present, it may be the first time they hear the patient describe his or her symptoms, and this could come as a surprise to them.

What questions should I ask a psychotic patient?

• “Do you ever feel things are not real?
• Do you worry that others may be hostile toward you or supporting you?
• “Do you ever hear things other people don’t hear?” …
• “Do you ever things other people don’t see?”
• “Are the voices outside or inside your head?” ( …
• Do you ever experience having thoughts forced into your head?

What screening questionnaire is used for schizophrenia?

The established scales PANSS, SAPS, and SANS have been utilized to objectively evaluate schizophrenia symptoms. It serves as a “gold standard” in treatment studies because it is adaptable.