Clinical Interviewing: An Essential but Neglected Method of Medicine

Giovanni A. Fava, Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA.
Nicoletta Sonino, Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA.
David C. Aron, Case Western Reserve University, Cleveland, Ohio, USA.
Richard Balon, Departments of Psychiatry and Behavioral Sciences and Anesthesiology, Wayne State University, Detroit, Michigan, USA.
Carmen Berrocal Montiel, Department of Surgical, Medical and Molecular Pathology, and Critical Care Medicine, University of Pisa, Pisa, Italy.
Jianxin Cao, Changzhou First People's Hospital and Psychosomatic Gastroenterology Institute, Soochow University, Changzhou, China.
John Concato, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
Ajandek Eory, Department of Family Medicine, Semmelweis University, Budapest, Hungary.
Ralph I. Horwitz, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA.
Chiara Rafanelli, Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy.
Ulrich Schnyder, University of Zurich, Zurich, Switzerland.
Hongxing Wang, Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Thomas N. Wise, Department of Psychiatry, Inova Health Systems, Falls Church, Virginia, USA.
Jesse H. Wright, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Stephan Zipfel, Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tubingen, Tubingen, Germany.
Chiara Patierno, Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy.

Document Type

Journal Article

Publication Date

2-21-2024

Journal

Psychotherapy and psychosomatics

DOI

10.1159/000536490

Keywords

Assessment; Clinical interviewing; Diagnosis; Health attitudes; Medical history

Abstract

Clinical interviewing is the basic method to understand how a person feels and what are the presenting complaints, obtain medical history, evaluate personal attitudes and behavior related to health and disease, give the patient information about diagnosis, prognosis, and treatment, and establish a bond between patient and physician that is crucial for shared decision making and self-management. However, the value of this basic skill is threatened by time pressures and emphasis on technology. Current health care trends privilege expensive tests and procedures and tag the time devoted to interaction with the patient as lacking cost-effectiveness. Instead, the time spent to inquire about problems and life setting may actually help to avoid further testing, procedures, and referrals. Moreover, the dialogue between patient and physician is an essential instrument to increase patient's motivation to engage in healthy behavior. The aim of this paper was to provide an overview of clinical interviewing and its optimal use in relation to style, flow and hypothesis testing, clinical domains, modifications according to settings and goals, and teaching. This review points to the primacy of interviewing in the clinical process. The quality of interviewing determines the quality of data that are collected and, eventually, of assessment and treatment. Thus, interviewing deserves more attention in educational training and more space in clinical encounters than it is currently receiving.

Department

Psychiatry and Behavioral Sciences

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