Start of Interview

Clinician:
"Hi, I’m [Your Name], and I’ll be doing your psychiatric evaluation today. Please feel free to make
up any details you’d like — this is a simulation, and you're roleplaying someone experiencing
depression. We’ll cover your current symptoms, background, and medical history, and then I’ll
complete some observations and ask a checklist of common psychiatric symptoms. Sound good?

I. A. Identifying Data

“Let’s start with some basic information.”

 Can you tell me your name, age, and pronouns?

 What do you do for work or how do you spend most of your time?

 Who do you live with?

 What is your relationship status?

 Are you currently working, in school, retired, or something else?

I. B. Chief Complaint

“What’s the main reason you’re here today — how would you describe the problem in your own
words?”

I. C. History of Present Illness (HPI)

“Let’s talk more about what’s been going on lately.”

 When did these symptoms first start?

 Was anything going on in your life at that time?

 How have your symptoms changed over time?

 How have they affected your sleep, appetite, energy, concentration, relationships, or
work/school?

 Any physical symptoms like fatigue, aches, or changes in weight?

 Have you had similar symptoms in the past?

 What have you done to cope with or treat these symptoms?

 Have you had any thoughts of harming yourself or ending your life? Any plans or past
attempts?

I. D. Past Psychiatric and Medical History

Psychiatric:

“Have you ever had mental health treatment in the past?”

 Previous therapy or psychiatric medications?

 Past suicide attempts or self-injurious behavior?

Medical:

“How about your physical health?”

 Chronic illnesses or past surgeries?

 Any current medications?

 Any allergies to medications?

I. E. Family History

“Do any mental health issues run in your family?”

 Depression, anxiety, bipolar disorder, schizophrenia, suicide, or substance use?

 Significant medical conditions in the family?

I. F. Personal History

1. Early Childhood:

 Where did you grow up, and who raised you?

 How would you describe your early family life?

 Any history of trauma or adverse experiences?

2. Middle Childhood:

 How was your experience in elementary school?

 Any problems with attention, behavior, or learning?

 Relationships with peers?

3. Later Childhood / Adolescence:

 How was high school for you — socially and academically?

 Any issues with mood, behavior, or substance use?

 Any involvement with the law?

4. Adulthood:

 Have you been in long-term relationships or married?

 Do you have children?

 What kinds of jobs have you held?

 Any legal or financial problems?

 Are you currently sexually active?

 Do you have any concerns about sexuality, gender identity, or relationships?

 Have you served in the military?

 Do religion, spirituality, or your personal values play a meaningful role in your life?

I. G. Clinician’s Observations and Impressions

(For your notes – not read aloud)

 General demeanor, speech, body language

 Emotional expression, rapport

 Coherence of the narrative

 Apparent risk level

 Initial diagnostic impressions

II. G – Judgment

“Let’s say you found a stamped, addressed envelope lying on the street — what would you do
with it?”

(Or alternative: “If you smelled smoke in a crowded movie theater, what would you do?”)

II. G. Psychiatric Review of Systems (ROS)

“Last part — I’ll read through some symptoms, and you can tell me yes or no if they’ve affected
you recently or in the past. If anything stands out, you are welcome to explain further or clarify.”

1. Mood Symptoms:

 Depressed mood?

 Loss of interest or pleasure in things you usually enjoy?

 Mood swings or irritability?

 Feelings of hopelessness, helplessness, or worthlessness?

 Excessive guilt?

 Low energy or fatigue?

 Feelings of being "down" most of the day, nearly every day?

 Suicidal thoughts, plans, or attempts?

2. Anxiety Symptoms:
  Feeling nervous or on edge?

 Panic attacks?

 Excessive worry or fear?

 Avoidance of social situations?

 Social anxiety or fear of judgment?

 Obsessions (unwanted, intrusive thoughts)?

 Compulsions (rituals or repetitive behaviors)?

 Physical symptoms of anxiety (e.g., restlessness, trembling, dizziness)?

3. Psychotic Symptoms:

 Seeing or hearing things that others don't?

 Feeling like others are watching, following, or plotting against you?

 Paranoia or suspicious thoughts?

 Delusions (beliefs that are not grounded in reality)?

 Disorganized thoughts or speech?

4. Other:

 ADHD Symptoms:

o Difficulty paying attention or staying focused?

o Easily distracted or forgetful in daily activities?

o Difficulty completing tasks or following through on responsibilities?

o Restlessness or trouble sitting still?

o Impulsivity (e.g., interrupting, making decisions without thinking)?

 Eating Disorder Symptoms:

o Preoccupation with weight, body image, or food?

o Restricting food intake or excessive dieting?

o Binge eating episodes?

o Compensatory behaviors (e.g., vomiting, excessive exercise)?

o Extreme fear of gaining weight or becoming fat?

Closing

“Thanks for answering all those questions — I know that was a lot. Is there anything else you’d
like to share before we wrap up?”