DSM5

When to call a Psychiatry Consult

1. Psychiatric process impacting decision-making:
   • Psychosis
   • Delirium/dementia
   • Depression/mania
   • Acute intoxication
   • Intellectual disability
2. High risk situations:
   • "High price" of refusal vs. consent
   • Patient inconsistency
   • Disagreement among treatment team, family, etc.

Interview Questions

• Tell me what brings you here (Chief Complaint)
• When did that begin? (Onset)
• How long has it lasted? (Duration)
• Have you had similar episodes before?
• What is your baseline like?
• What factors contributed? (Predisposing, Precipitating, Perpetuating, Protecting against)
• Other HPI info (how got here, etc)
• How is your mood right now?
• Sleep, appetite, concentration, energy
• Activities, interest
• Feelings of Guilt?
• Thoughts of SI, HI?
  • Thoughts that world would be better without you here
  • Thoughts of hurting self
    • Method, rehearsal, plan
• AVH?
• Anybody out to get you?