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.