6 - Mental Health Flashcards
Mental health
finding balance in all aspects of life; can vary over time across a continuum
Mental disorder
constellations of co-occurring symptoms involving alterations in thought, experience, and emotion
Level of impairment may range from absence of illness to maximal illness
Concurrent Disorder
mental health + substance use disorder
Comorbidity
the simultaneous presence of two or more diseases or medical conditions in a patient.
mental status exam (MSE)?
Structured way of observing/describing a person current state of mind
Assess developmental neurological and psychiatric disorders
Involves emotional and cognitive functioning
I. Appearance
II. Behaviour
Mood/Affect, speech
III. Cognition
Consciousness, Orientation, Memory, Attention/Concentraation, Comprehension and Abstract Reasoning
IV. Thinking
Perception, Content, Process, Insight, Judgment
Level of Consciousness
Coma Stupor/Semi-Coma Obtunded Lethargic (somnolent): Alert Acute Confussional State
Coma
fully unconscious, no response to pain/stimuli
Stupor/Semi-Coma
spontaneously unconscious, respond to pain
Obtunded
between lethargy/coma, need constant stimuli, sleep a lot
Lethargic (somnolent):
not fully alert, sleeps when not stimulated, drozy, respond slowly
Alert
awake, readily aroused, orientated
Acute Confussional State
(Delirium): clouding of consciousness, incoherent conversation, impaired memory
Thought Process
The way a patient thinks should be logical, goal directed, coherent and relevant.
Does the person make sense, can you follow what their saying?
Thought Content
What a patient says should be consistent and logical. Identify and obsessions or compulsions
Perceptions
patient should be consistently aware of reality and his/her reality. Perceptions should be congruent
Flat Affect:
lack of emotional responce
Dysphoric:
unease or dissatisfaction with life
Euphoric:
unusually cheerful/elated
Affect:
display of fellings/state of mind
Blunted:
reduced emotional intensity
Ambivalence:
esistance of opposing emotions toward an idea, object, person
Lability:
rapid shift of emotions
- affect is characterized by repeated, rapid and abrupt shifts
Constricted:
limited variability in despary of emotion
Elation:
joy/optimism
Depersonalization
loss of identity, feeling estranged, perplexed about own identity and meaning of existence
- this is an alteration in the perception or experience of the self so that feeling’s of one’s own reality is lost
- creates a sense of estrangement or unreality about one’s self or parts of the self
- for example, one may feel that body parts have changed or that one is viewing himself from a distance
- the out of body experiences reported in various media may indeed be occasions of depersonalization
Dysarthria
difficult or unclear articulation of speech slurred/slow,
anarthria can’t articulate words at all
Echoladia
meaningless repetition/imitating a person’s speech
A speech pattern in which the person repeats the phrases or parts of the phrases that another has spoken. Essentially it is a parroting of words by another (turn on the lights, the lights, the lights)
Palilalia
automatic repetition of one’s OWN words.
repetition of phrases/words
Alogia
impaired thinking/reduced speech output
Pressured speech
loud, volumous
Refers to speech that is increased in amount and rate. It also may be loud and empathetic. This type of speech is difficult to interrupt. An everyday similarity might be the type of speech from someone who is recounting a terrifying/dramatic experience moments after it happened
Word Salad:
sequence of words with no words
This is a disturbance that is accurately represented by its name. The thoughts are so severely disrupted that the speech is a verbal salad; a sequence of very muddled words (puppy paper eating) schizophrenia, brain injury, dementia
Phobia
strong persistent, irrational fear of an object or situation, feeling driven to avoid it
Hypochondriasis
morbid worrying about own health, feeling sick with no actual basis for that assumption
Obsession
unwanted, persistent thoughts or impulses experienced as intrusive and senseless, logic does not purge them from consciousness
obsessions (thoughts)- defined as recurrent persistent ideas, thoughts, images or impulses that are recognized by the person as irrational yet persist despite their endeavours to rid them.
• assessment: ask them if they have and ideas or thoughts that they continually think about. What happens when they try to stop thinking about it
Compulsion
unwanted repetitive act thought to neutralize or prevent discomfort or some dreaded event
compulsions (behaviors) - defined as repetitive and persistent behavior that is performed according to certain rules and is contrary to the wishes of the person. If is roughly the behavioral analogy of the obsession
Delusions
fixed falser beliefs, irrational beliefs, clinging to delusion despite objective evidence to country
Blocking
sudden interruption in train of though, seems relation to strong emotion
a term that refers to a sudden obstruction or interruption in the spontaneous flow of thinking. Note that it does not refer to the temporary failure to remember a particular word such as someone’s name. Rather it is a disruption in the flow of the thought process. (losing train of thought)
Confabulation
fabricating events to fill in memory gaps
Neologism
making up words (pepsidiction = pepsi addiction)
coining a new word invented word has no meaning except for patient, several words may be condensed
new words or the combination of two or more conventional words that are coined by a person and not understood by others (common in children, but in adults may indicate brain damage or schizophrenia)
Circumstantiality
talking with excessive and unnecessary detail, delay in reaching point, sentences have a meaningful connection but are irrelevant
Circumlocution
roundabout expression substituting a phrase when a patient cannot think of name of object
Lossening associations
shifting from one topic to an unrelated topic, the patient seems unaware that topics are unconnected
Flight of ideas
abrupt change, rapid skipping from topic to topic, practically continuous flow of accelerated speech topics usually have recognizable association or are play on words
a nearly continuous flow of accelerated speech with abrupt changes from topic to topic. Such shifts are often based in distracting stimuli or in recognizable associations, for example, play on words.
There is characteristically an element of emotional excitement that accompanies the rapid rate of speech production. This excitement accompanied by the accelerated rate gives flight of ideas a different quality than the disjointed speech that reflects looseness of associations.
Looseness of associations is characterized by illogical linkages of ideas whereas flight of ideas is characterized by rapidly changing linkages.
Clanging
word choice based on sounds not meaning, included nonsense rhymes and puns
Clang associations - In this speech pattern, the linkage of ideas is based upon sound and not upon related meaning (rhyming: “I have to go you know”; “to and fro before the snow blows”) bipolar, schizophrenia
Perseveration
persistant repeating of verbal or motor repsonce even with varied stimuli
a term that can be applied to motor as well as verbal activities. In this context the verbal application is pertinent. (my belt, where’s my belt, I have a belt)
random letter test
40 dif letters, ask person to tap for every letter “b” they hear
Immediate memory
3 types of memory
Immediate
Recent
remote
Digit repetition
say specific digits back
judgement
the ability to reach a logical decision about a situation and to choose a course of action after examining and analyzing various possibiliti
nihilism,
rejection of all religious or moral principles
Catatonic posturing
spontaneous and active maintenance of a posture against gravity.
the involuntary assumption of peculiar postures (limbs or body)that are usually held for long periods of time
Montreal Cognitive Assessment (MoCA)
Sensitivity of 90% for detecting mild cognitive impairment
Echopraxia
meaningless repetition/imitating a person’s MOVEMENT
Waxy flexibility
a condition in which a patient’s limbs retain any position into which they are manipulated by another person
- the propensity for a person to permit their limbs or body to be placed in certain positions which they hold… it’s as if they are made of wax that can be shaped
Catatonic negativism
opposition or no response to instructions or external stimuli.
resistance to movement (or instruction)
