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Psychiatry > Basic principles and assessment > Flashcards

Basic principles and assessment Flashcards

1
Q

Components of basic psychiatric assessment

A 
HOPC 
Past psych history
Personal Hx
Social Hx (esp substance use)
Family Hx
Forensic Hx
Past medical Hx, DHx, allergies
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2
Q

Components of mental state examination

A 
Appearance and behaviour
Speech
Thoughts
Mood
Perception
Cognition
Insight
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3
Q

Key points when asking about current psychiatric treatment

A

Side effects + adherence
Any recent changes to meds in general
Injections/depots
Allergies

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4
Q

Key questions to ask in PMHx for females?

A

Obstetric/menstrual Hx + associated psychiatric pathology

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5
Q

Minimum information to be obtained from FHx

A

Hx of self-harm/suicide (sudden unexpected death)
Any children living in household
Parents, siblings, children - relationship + medical condition

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6
Q

Key parts of personal Hx

A 
Walk + talk milestones
School/childhood
Current and past occupation, aspirations
Any horrible/frightening experiences?
Exposure to suicide in friends/family?
Do you have a partner at the moment? 
Who knows you best I could talk to?
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7
Q

Components of appearance/behaviour in MSE

A 
Eye contact
Rapport
Psychomotor retardation/agitation
Evidence of SH
Personal hygiene
Kemptness
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8
Q

Components of speech in MSE

A

Quantity (pressured, paucity)

Rate, tone, volume

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9
Q

Components of thoughts in MSE

A

Form: Thought disorder, flight of ideas
Content: Over-valued ideas, delusions, obsessions

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10
Q

Components of mood in MSE

A

Subjective + objective
Mood, constancy, congruency
Anhedonia is key!
Thoughts of self-harm/suicide

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11
Q

Definition of delusion

A

A belief firmly held on inadequate grounds, not appropriate to culture, not amenable to contrary evidence

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12
Q

Definition of over-valued idea

A

A preoccupying belief (with some logical basis) that dominates thoughts/actions despite recognising unreasonableness/evidence to the contrary

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13
Q

Common types of delusion

A 
Persecution
Control
Thought possession (insertion, withdrawal, broadcasting)
Reference
Love
Grandiosity (common in BPD)
Nihilistic
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14
Q

Definition of obsessions

A

Intrusive thoughts that are repetitive, recognised as unreasonable, have no logical basis, enter mind despite resistance. Ego-dystonic.

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15
Q

Components of perception in MSE

A

Deceptions: Hallucinations and illusions
Distortions: Hyperacusis and hypoacusis
Depersenalisation and derealisation (do you feel detached from yourself or the rest of the world?)

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16
Q

Distinction between hallucination and illusion

A

Hallucinations occur in the absence of stimuli

17
Q

Characterising hallucinations

A

Modality (Auditory most common psych)
Content (who is talking? What are they saying? 1st/2nd/3rd person)
Inside or outside (c.f. pseudo-hallucinations in EUPD)

18
Q

Situations where hallucinations are normal

A

Hypnogogic
Hypnopompic
Normal grief reaction

19
Q

Components of cognition in MSE

A

Concentration
Orientation
Memory

20
Q

Assessing insight in MSE

A

What do you think of your Dx, X?
What do you think has been happening?
Do you think you need treatment?

21
Q

Static risk factors for suicide

A

Male
Recent life crisis
Hx of self-harm/exposure to self-harm or suicide
Hx of drug/alcohol misuse

22
Q

Dynamic risk factors for suicide

A

Marital status
Living arrangements
Occupation
Plans: Intent, lethality, access to means, finalising arrangements
Psych disorder: Mood, personality, schizophrenia

23
Q

Protective factors for suicide

A

Strong religious faith
Family support
Children at home
Sense of responsibility

24
Q

Risk factors for harming others

A 
Plan, intent, lethality, access to means
Hx of violence
Psych illness
Hx of trauma/abuse
Substance misuse
25
Q

What is the care programme approach

A

Model for community psychiatric care

26
Q

Components of CPA

A

Detailed assessment: identifying psychiatric, medical, and social needs
Key worker: CPN or social worker responsible for coordination + administration of treatment and reporting back any changes/liaising with other agencies
Care plan: Drawn up in consultation w/ service user + nearest relative
Regular review: Usually 6-monthly

27
Q

Risks to consider

A

To self, from self: Self-harm, self-neglect, misuse of medication, substance misuse
To treatment: Non-compliance, absconsion
From others: Violence, exploitation
To others: Driving, fire-setting, violence, sexual offending, damage to property
To children: Safeguarding concerns

Psychiatry (20 decks)

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