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Psych Unit 1 > 1 Psychiatric Interviews and Mental Status Interview > Flashcards

1 Psychiatric Interviews and Mental Status Interview Flashcards

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1
Q

_______% of all patients are diagnostic or sub-clinical for psychiatri illness but only ____% of all patients consult for psychiatric reasons

A

30-40%

~5%

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2
Q

The majority of patients ultimately diagnosed with ADHD initially presented to ___________.

A

Primary care or pediatrics

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3
Q

In deciding whether to refer a patient to psych, what is the most important question to ask yourself?

A

Could this patient cause harm (to themselves or to others)?

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4
Q

The 12 domains of the mental status exam are used to describe…

A

The patient’s current state of mind

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5
Q

The mental status exam is the basis for…

A

Dx (DSM criteria), psychiatric formulation, and treatment plan

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6
Q

What are the 12 domains of the mental status exam?

A 
Appearance
Alertness/orientation
Speech
Motor behavior
Mood and Affect
Attention
Memory
Perception
Insight
Judgement 
Thought content
Thought processes
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7
Q

Name the domain…

Grooming/clothing
Skin lesions, body mods
Habitus or physique

A

Appearance

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8
Q

Name the domain…

“Patient attended interview well kempt and appropriately dressed”

A

Appearance

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9
Q

Name the domain…

“Patient arrived to the appointment disheveled and in dirty clothes”

A

Appearance

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10
Q

Name the domain…

Assessing a patient’s level of consciousness, alertness, or state of awareness of the environment

A

Alertness and Orietation

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11
Q

Name the domain…

“Patient is A&O x 4”

A

Alertness and Orientation

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12
Q

What does the 4 stand for in “A&Ox4”?

A

Person
Place
Time
Situation

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13
Q

If a patient is disoriented, it’s typically NOT a …

A

Not a psych issue

Could be delirium, dementia, neurological problem, schizophrenia…

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14
Q

Name the domain…

Observing spontaneous speech and language tests

A

Speech

But it’s speech PRODUCTION, not CONTENT

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15
Q

When observing a patient’s speech, you are interested in speech ________, not speech _______.

A

Speech production, not content

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16
Q

When observing a patient’s speech, consider…

A

Rate

Volume

Type
• Slurred
• Mumbled
• Aphasia
• Word salad
• Clang assoc
• Neologisms
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17
Q

Speech is, by and large, fluent, but it may appear to not make sense to listeners, as the patients themselves cannot understand what they are saying.

A

Wernicke’s aphasia

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18
Q

Name the domain…

“Patient was observed ambulatory without evidence of psychomotor retardation or agitation”

A

Motor Behavior

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19
Q

Name the domain…

“Patient exhibited several akathisia”

A

Motor Behavior

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20
Q

Examples of different types of motor behaviors

A 
Hyperactive
Hypoactive (psychomotor retardation)
Rigid
Restless/akathisia
Combative
Tics
Eye contact
Gait

Note - many motor behaviors can be medically induced

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21
Q

Name the domain…

Sustained emotion that affects a person’s view of the world

A

Mood

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22
Q

Name the domain…

Patient’s subjective description of his or her emotional state in his or her own words

A

Mood

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23
Q

Name the domain…

“She described herself as depressed, which caused her great frustration”

A

Mood

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24
Q

Descriptors for the mood domain

A 
Depressed, sad
Irritable
Anxious
Angry
Euphoric
Apathetic
Futile
Frightened
Guilty
Normal
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25
Q

Name the domain…

Emotion conveyed via non-verbals

A

Affect

26
Q

Name the domain…

An observable feeling or tone expressed through voice, facial expression, and demeanor

A

Affect

Described by CLINICIAN, not the patient (that’s mood)

27
Q

Descriptors for Affect domain

A 
Normal/full
Blunted, flat, constricted
Exaggerated
Labeled
Appropriate/inappropriate (to the conversation)
28
Q

Name the domain…

The ability to focus or concentrate over time on one task or activity

A

Attention/attitude

29
Q

Name the domain…

Patient’s rapport, approach to interview

A

Attention/attitude

30
Q

Name the domain…

The process of registering or recording info

A

Memory

31
Q

Childhood recollections are considered ______ memory

A

Remote

32
Q

Current events within the past few months are considered _______ memory

A

Recent remote

33
Q

Recalling what you had for breakfast is considered ______ memory

A

Recent

34
Q

The word list recall or repeating a phone number back is a test of ______ memory

A

Immediate retention and recall

35
Q

The 6-digit test is an assessment of _______ but is also a _______ test

A

Immediate retention and recall

Attention test

36
Q

Name the domain…

Sensory awareness of objects in the environment and their interrelationships

A

Perception

Also refers to internal stimuli

37
Q

False sensory perception NOT associated with REAL external stimuli

A

Hallucinations

38
Q

Examples of different types of hallucinations

A 
Auditory
Visual (think drugs)
Olfactory
Tactile (think meth)
Gustatory
39
Q

What is the most common type of hallucination?

A

Auditory

40
Q

Misperception or misinterpretation of REAL external stimuli

A

Illusions

41
Q

A person’s subjective sense of being unreal, strange, or unfamiliar

A

Depersonalization

Think schizophrenia

42
Q

A subjective sense that the environment is strange or unreal

A

Derealization

43
Q

The feeling of bugs crawling on or under the skin

A

Formication

Think meth or other psycho-stimulants

44
Q

Name the domain…

Patient’s awareness that Sx or disturbed behaviors are normal or abnormal

A

Insight

45
Q

Name the domain…

Patient’s understanding of his/her illness

A

Insight

Can complicate consent for treatment

46
Q

Name the domain…

Is a continuum over several encounters

A

Insight

  1. Recognition they may have mental illness
  2. Compliance with treatment plan
  3. Re-label false mental events
47
Q

Which type of mental illness is most commonly associated with poor insight?

A

Personality disorders

48
Q

Name the domain…

Process of comparing and evaluating alternatives when deciding on a course of action

A

Judgement

49
Q

Name the domain…

Can they make sound, reasonable, responsible decisions?
How would they respond in real-life challenges?

A

Judgement

50
Q

Name the domain…

“If you found a stamped, addressed envelope lying on the street, what would you do with it?”

A

Judgement

51
Q

Name the domain…

WHAT the patient thinks about and the focus of their concerns

A

Thought content

52
Q

Name the domain…

Extent to which the patient believe’s their thoughts/conviction

A

Thought content

53
Q

Fixed, false, personal beliefs that are not shared by other members of the person’s culture

Cannot be corrected by reasoning

A

Delusions

54
Q

What are the different types of delusion?

A 
Paranoid
Grandeur
Nihilistic
Ideas of reference
Ideas of influence
Persecution
55
Q

Recurrent, uncontrollable THOUGHTS, images, or impulses

A

Obsessions

They are not false thoughts, but they are prominent

56
Q

Repetitive BEHAVIORS or mental acts that a person feels driven to perform

A

Thought content

57
Q

Persistent, irrational, exaggerated fear of a specific stimulus or situation (but pt knows it’s irrational)

A

Phobias

58
Q

_______ can be accompanied by a compelling desire to avoid a stimulus

A

Phobias

59
Q

Name the domain…

Quantity, tempo, and coherence of a patient’s thought

A

Thought processes

60
Q

Name the domain…

The logic, coherence, and relevance of the patient’s thought as it leads to selected goals

A

Thought processes

HOW a patient thinks

61
Q

Examples of different types of thought processes to document…

A 
Rapid thinking
Slow or hesitant thinking
Goal-directed thinking
Relevant responses
Loose associations, flight of ideas
Tangential, circumstantial
Perseveration
Blocking
62
Q

______ is the basis to formulate any psychiatric diagnosis

______ is a brief neuropsychological test to screen for dementia

A

MSE (Mental Status Exam)

MMSE (Mini-Mental Status Exam)

Psych Unit 1 (6 decks)

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