Assessment and history taking Flashcards
What nature of symptoms should be asked for psychotic symptoms?
Delusions, hallucinations, thought disorder
What nature of symptoms should be asked for affective symptoms?
Mood Energy Sleep Concentration Appetite Weight
What nature of symptoms should be asked for anxiety symptoms?
Physical and physiological symptoms
What should be asked in a past psychiatric history?
Previous admissions
Previous attendance at GP
Previous treatment and if it has been successful
Previous self harm or suicide attempts
What is included in the personal history?
This is an opportunity for the patient to give their life narrative and for insight into potential risk factors
What is included in the forensic history?
This is focussing on arrests or any undetected crimes, asking if they have ever done anything that might have got them in trouble with the police
What is the patients pre morbid personality?
This is asking how would you describe your normal self? finding out what they are like at normal baseline
What are the elements of a mental state examination?
Appearance and behaviour Speech Mood Thoughts Perception Cognitive function Insight
What should be covered in the appearance and behaviour section of the mental state examination?
It should be a description so someone could identify the individual from the description:
Gender, age, ethnicity, personal care, distinctive characteristics
What should be covered by the speech section of the mental state examination?
This should include:
- Speed
- Tone
- Coherence
- Volume
What should be covered by the mood section of the mental state examination?
A subjective view of the patients mood from their point of view followed by an objective view from the physician
How should thought be assessed in the mental state examination?
This can only be determined by what the patient is saying, includes:
-Acceleration - speech is accelerated with logical connection between each sequential idea
-Circumstantial - Important facts and not differentiated from detail
-Loosening of associations - Loss of logical connections between each sequential idea
Thought Blocking - Sudden stop in thought flow
What different perceptions might be recorded in the mental state examination?
Sensory distortions
Illusions - misconceptions of a real object
Hallucinations - perception without an external stimulus
How is cognitive function assessed in a mental state examination?
This is assessed by orientation to time, place and person
How is insight into illness assessed in the mental state examination?
Asking the patient how they explain their experiences
