The psychiatric review of symptoms: a screening tool for family physicians

The psychiatric review of symptoms is a useful screening tool for identifying patients who have psychiatric disorders. The approach begins with a mnemonic encompassing the major psychiatric disorders: depression, personality disorders, substance abuse disorders, anxiety disorders, somatization disorder, eating disorders, cognitive disorders and psychotic disorders. For each category, an initial screening question is used, with a positive response leading to more detailed diagnostic questions. Useful interviewing techniques include transitioning from one subject to another rather than abruptly changing subjects, normalization (phrasing a question to convey to the patient that such behavior is normal or understandable) and symptom assumption (phrasing a question to imply that it is assumed the patient has engaged in such behavior). The psychiatric review of symptoms is both rapid and thorough, and can be readily incorporated into the standard history and physical examination.