Psychiatric History of Presenting Illness Mnemonic

To the Editor: It is essential for individuals in the medical and psychiatric fields to be skilled in obtaining a psychiatric history. During my training at the University of Toronto, my preceptor, Dr Gerald Shugar, introduced the 6 Ss: Start, Setting, Stressors, Symptoms, Sequelae, and Supports.

Over the years, I have adopted and modified the 6 Ss to develop a mnemonic that has evolved into its current version, which is still used by my trainees and referring physicians from other specialties. To aid in taking a comprehensive psychiatric history of presenting illness (HPI), I developed the following mnemonic device: the “Psychiatric HPI 9 Ss.” Each letter represents an essential part of the psychiatric HPI, as follows:

1. Start
2. State: circumstances of the event
3. Stressors: bio-psycho-social
4. Symptoms: bio-psycho-social
5. Psychosis
6. Suicide
7. Substance: prescribed and illegal
8. State of function: current
9. Systems review: other psychiatric diagnoses

The 9 Ss are easily remembered and can be utilized by students, residents, psychiatrists, and other clinicians to facilitate the organized collection of relevant information when obtaining the psychiatric HPI.

Article Information

Published Online: July 18, 2024. https://doi.org/10.4088/PCC.23lr03699
© 2024 Physicians Postgraduate Press, Inc.
Prim Care Companion CNS Disord 2024;26(4):23lr03699
To Cite: Aljeshi AA. Psychiatric history of presenting illness mnemonic. Prim Care Companion CNS Disord. 2024;26(4):23lr03699.
Author Affiliation: Johns Hopkins Aramco Healthcare Center, Dhahran, Eastern Province, Saudi Arabia.
Corresponding Author: Abdulsamad A. Aljeshi, MBBS, FRCPC, Johns Hopkins Aramco Healthcare Center, PO Box 5888, Almujamma, Saudi Aramco, Dhahran, Eastern Province, Saudi Arabia 31311 ([email protected]).
Relevant Financial Relationships: None.
Funding/Support: None.