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The psychiatric interview involves the development of a history of the patient’s present illness, a mental status examination (MSE), an assessment of dangerousness and substance use, and a differential diagnosis and treatment plan. Developmental, family, and social histories are also part of the initial interview, as is a history of prior psychiatric treatments and co-occurring medical conditions. A therapeutic alliance and a therapeutic effect are both reasonable expectations, as is some sort of psychological understanding of the patient. This information is generally compiled within an often-clunky electronic medical record. Such efforts are a challenge, especially when the clinician is also expected to be kind, tactful, patient, and friendly.
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