Family diagnoses missed on a clinical inpatient service

Methods for taking family psychiatric histories have been developed primarily for research rather than clinical settings. The authors compared family histories obtained independently by a research team and by PGY-3 residents on 52 consecutively admitted adult psychiatric inpatients. In contrast to the residents, the research team used a family tree, screening questions, and a structured interview based on diagnostic criteria and identified more than four times as many diagnoses in relatives as did the residents. The results demonstrate that a family history strategy derived from research methodology significantly enhances the gathering of important diagnostic information in a clinical inpatient setting.