Assessment Flashcards
What are the additional things to ask about when taking a psychiatric history
Past psychiatric history
Birth
Childhood
Education/employment
Relationships
Past forensic history
Detailed social history
What are the 3 main methods of building a good rapport in a psychiatric history
Signpost
Normalise
Acknowledge embarrassment
What are the 7 components of a mental state examination
Appearance and behaviour
Speech
Emotion (mood)
Perception
Thoughts
Insight
Cognition
What does an MSE give an indication of
Patient’s psychological functioning at a given point in time
What things should be considered in the appearance and behaviour section of an MSE
Physical state
Clothing and accessories
Personal hygiene
Eye contact
Facial expressions
Body language
Motor activity and abnormal movements
Level of arousal
Ability to build rapport
Disinhibition
What things should be considered in the speech section of an MSE
Rate
Rhythm
Volume
Content
Quantity
Tone
Dysarthria
What is the difference between mood and affect
Mood
- Sustained experience of emotions over a period of time
- Assessed subjectively and objectively
Affect
- Emotions in the moment
- Posture, facial expressions…
What are delusions
Fixed false beliefs
Firmly held despite evidence to the contrary
Go against person’s normal social and cultural beliefs
What are the different types of delusions
Grandiose
Persecutory
Reference (assign significance to random event)
Guilt
Hypochondriacal
De Clerambault’s syndrome (think someone is in love with them)
Othello syndrome (morbid jealousy, think partner is unfaithful)
Capgras’ syndrome (things replaced by duplicates)
Nihilistic (worthless/dying)
Infestation
What is the difference between obsessional thoughts and overvalued ideas
Obsessional thoughts
- Enter mind despite efforts to resist them
Overvalued ideas
- Strongly held beliefs
- Can be put out of mind with effort
What are the 4 main abnormal thought forms
Loosening of association
Circumstantiality
Neologisms
Perseveration
What is loosening of association
Loss of normal structure of thinking
Found in schizophrenia
Derailment of thoughts (sequence of unrelated ideas)
Tangential thinking (divert, do not return)
Word salad (senseless repetition of sounds or phrases)
What is circumstantiality
Lots of unnecessary details or digressions
Eventually return to original point
What is neologism
Making up new words
Assigning new meanings to existing words
Seen in schizophrenia and autism
What is perseveration
Uncontrollable repetition of a particular response
