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The family history includes available information about the patient's family constellation and the strength of relationships with family members. Information obtained about close family members, including parents and, if applicable, siblings, spouse, and children, will include general information (e.g., current age or age at time of death, position in sibship, occupation), quality of relationship to the patient, and health status. General medical and psychiatric illness in close relatives is noted, including disorders that may be familial or may strongly affect the family environment. A history of adoption or foster care or disruptions in the family environment because of divorce, remarriage, prolonged absences of family members (e.g., occupational absences, hospitalization, incarceration), or deaths may be useful to elicit. Family history information will also consist of any history of psychiatric hospitalizations, illness, or significant symptoms, including suicide and attempted suicide in first- and second-degree relatives. More specific questions are important to ask depending on the patient's clinical presentation, given the heritability of psychosis; mood disorders; anxiety disorders; cognitive disorders; learning disabilities; developmental disabilities, including autism, hyperactivity, or attention deficit disorder; substance use disorders; and antisocial behavior. For family members who have experienced psychiatric symptoms, it is helpful to learn the treatment received and their response to treatment. It is also important to determine first- and second-degree relatives' history of medical disorders (67), particularly those with relevance to psychiatric illness and treatment, such as cardiac, neurological, and endocrine disorders. If family health problems are current, this may contribute psychological or financial stresses for the patient.

Construction of a formal pedigree or genogram is often helpful in delineating family relationships and identifying a family history of illness. The web sites of the American Medical Association (68), the American Society of Human Genetics (69), and the March of Dimes (70) provide additional details on the drawing of pedigrees.

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