Personal Psychiatric History

Inquiries regarding the presence of psychiatric problems are most easily made within the general review of systems. Responses to questions such as "Have you ever had any emotional problems?" allow further exploration about the nature of the illness, its treatment, and the level of disability. This is especially important when the patient reports having had a "nervous breakdown," as this term has no diagnostic utility.

When patients respond in the affirmative to the initial screening question about emotional problems, the physician should ask them about thoughts of suicide. These thoughts are unlikely to be reported spontaneously by the patient and give information about the potential for self-injury. Such questions might be formulated as "Have you ever felt so bad that you wished you were dead?" or "Have you ever felt so bad that you thought of taking your life?"

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