anamnese

Anamnese is the medical history obtained from a patient during the clinical interview. The term, often used in German and other European languages, is commonly translated as anamnesis in English. It encompasses personal health history, current symptoms, and relevant background information that can influence diagnosis and treatment. The purpose is to gather information about the onset, duration, course, and severity of symptoms, identify risk factors, prior illnesses, medications, and allergies, and establish a baseline for ongoing care. The history is typically organized into sections including present illness or history of presenting illness, past medical history, medications and allergies, family history, social history, and a review of systems.

The process emphasizes patient-centered interviewing, using open-ended questions to allow free patient narrative, followed by focused questions to clarify details. Observations, collateral information from relatives or caregivers, and review of medical records may supplement the interview. Clinicians document the information in the medical record to support diagnostic reasoning, risk assessment, and management planning, while ensuring confidentiality and cultural sensitivity.

Limitations include reliance on patient memory and communication ability, language barriers, cognition, and the clinician's interviewing skills. Miscommunication, incomplete records, or deliberate nondisclosure can affect accuracy. Anamnese remains a foundational aspect of medical assessment, complementing the physical examination and diagnostic testing, and is tailored to the clinical setting, whether primary care, emergency, pediatrics, or psychiatry.