definitions Flashcards
section 2 of the MHA
Assessment made by an AMHP and 2 doctors, one of which is section 12 approved
This section allows a mentally ill person to be detained for 28 days and administered medication against their will (consent should always be sought first)
In the best interest of the patient or others (prevention of harm)
Can be disputed by a tribunal
section 3 of the MHA
Detention of a mentally ill person for 6 months and administered medication against will if needs be.
Assessment carried out by an AMHP and 2 doctors
Section 136
Police sectioning powers enabling them to remove a person who appears mentally ill from a public space to a place of safety
section 135
Police sectioning powers enabling them to remove a mentally ill patient from personal property to a place of safety so they can have a mental health assessment.
Examples of things to comment on on the appearance section of the MSE
How are they dressed
any scars, signs of self harm, signs of IVDU, tattoos
personal hygiene, hair, odour
weight
stigmata of disease (eg. jaundice)
Examples of things to comment on on the behaviour section of the MSE
maintaining eye contact
bizzare actions/movements (eg. jumping up and down, lip smaking, akanthesia, tremor, ticks)
Psychomotor retardation or agitation
body language
Examples of things to comment on on the speech section of the MSE
Tone- monotone/tremulous
rate- slow/ pressure of speech
volume
rhythm, fluidity- stammering/ slurring
quantity-minimal/ excessive
Examples of things to comment on on the thought section of the MSE
Thought form:
-uninteruptibility
-flight of ideas
-tangibility
-circumstantuality
-poverty of speech
-loose associations
- thought blocking
- perseveration
-Are thoughts formed and verbilised
Thought content:
-delusions
-suicidal ideation
- obsessions
- compulsions
- overvalued ideas
Thought possession
- insertion
- withdrawal
- broadcasting
Examples of things to comment on on the mood section of the MSE
subjective- what does the pt say their mood is. score of 1-10
objective (affect):
-elated, heightened (mania)
-irritable, frustration, angry (mania)
- flat affect (depression, psychosis)
-anxious, paranoid (paranoid schizophrenia)
-sad
congruency of affect- does the affect match the mood described by the pt
Examples of things to comment on on the Perception section of the MSE
Responding to external stimuli?
do they appear present in the room
hallucinations
pseudo-hallucinations (pt knows not real)
illusions
derealisation
Examples of things to comment on on the insight section of the MSE
Does the patient know why they are there
does the patient believe they are mentally unwell
does the patient believe they need medication/ do they think the medication is working
How is cognition formally assessed?
- are they orientated in time, place and person
what is their attention span and concentration levels like?
what their short-term memory is like?
formally assessed using eg:
MMSE
mini MOCA
Delusion
A firm, fixed belief based on inadequate grounds, despite significant argument or evidence to the contrary that is outside of cultural or religious norms.
eg.
persecutory- beleif that people are out to get them
grandiose- god like beliefs eg have special powers, is the best musician in the world
Illusion
misinterpretation of an external stimulus
eg. thinks a tree is a person
flight of ideas
Lots of different ideas coming out usually with pressured speech- usually with arbitrary connections
circumstanciality
unable to give an answer without giving lots of irrelevant and unecessary detail
tangential thoughts
digressions from the main topic of conversation that seem unconnected
neologisms
made up words
word salad
a mix of random words not making any sense
thought blocking
patient stopping mid thought and unable to remember what their thought was
perseveration
repeating words or phrases
Overvalued idea
an idea that is neither delusional or obsessional but is preocupying and dominating the pts thoughts
eg. if i go home to my country everything will be better
obsessions
repetitive thought, images or impulses that the patient is unable to get out of their head and they are aware that it is irrational but unable to stop
compulsions
an action the patient feels compelled to do despite knowing it is irrational
pseudo-hallucinations
a hallucination that the patient knows is not real
hallucination
a sensory perception (visual, auditory, smell) without an external stimulus
what is psychosis
a syndrome of symptoms causing someone to lose touch with reality
disrupted beliefs- delusion
disrupted perception- hallucination
disrupted thought- thought disorder
examples of delusions
GRANDIOSE vs PERSECUTORY
Reference- messages from eg. the TV
Nihilistic- eg. organs rotting and dying inside
erotomania- belief that someone (usually higher status) is in love with them
jealousy- spose cheating
misidentification
parasitosis (ekbom)- parasitic infeciton
