definitions

Question 1

section 2 of the MHA

Answer 1

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

Question 2

section 3 of the MHA

Answer 2

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

Question 3

Section 136

Answer 3

Police sectioning powers enabling them to remove a person who appears mentally ill from a public space to a place of safety

Question 4

section 135

Answer 4

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.

Question 5

Examples of things to comment on on the appearance section of the MSE

Answer 5

How are they dressed

any scars, signs of self harm, signs of IVDU, tattoos

personal hygiene, hair, odour

weight

stigmata of disease (eg. jaundice)

Question 6

Examples of things to comment on on the behaviour section of the MSE

Answer 6

maintaining eye contact

bizzare actions/movements (eg. jumping up and down, lip smaking, akanthesia, tremor, ticks)

Psychomotor retardation or agitation

body language

Question 7

Examples of things to comment on on the speech section of the MSE

Answer 7

Tone- monotone/tremulous
rate- slow/ pressure of speech
volume
rhythm, fluidity- stammering/ slurring
quantity-minimal/ excessive

Question 8

Examples of things to comment on on the thought section of the MSE

Answer 8

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

Question 9

Examples of things to comment on on the mood section of the MSE

Answer 9

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

Question 10

Examples of things to comment on on the Perception section of the MSE

Answer 10

Responding to external stimuli?
do they appear present in the room
hallucinations
pseudo-hallucinations (pt knows not real)
illusions
derealisation

Question 11

Examples of things to comment on on the insight section of the MSE

Answer 11

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

Question 12

How is cognition formally assessed?

Answer 12

• 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

Question 13

Delusion

Answer 13

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

Question 14

Illusion

Answer 14

misinterpretation of an external stimulus

eg. thinks a tree is a person

Question 15

flight of ideas

Answer 15

Lots of different ideas coming out usually with pressured speech- usually with arbitrary connections

Question 16

circumstanciality

Answer 16

unable to give an answer without giving lots of irrelevant and unecessary detail

Question 17

tangential thoughts

Answer 17

digressions from the main topic of conversation that seem unconnected

Question 18

neologisms

Answer 18

made up words

Question 19

word salad

Answer 19

a mix of random words not making any sense

Question 20

thought blocking

Answer 20

patient stopping mid thought and unable to remember what their thought was

Question 21

perseveration

Answer 21

repeating words or phrases

Question 22

Overvalued idea

Answer 22

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

Question 23

obsessions

Answer 23

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

Question 24

compulsions

Answer 24

an action the patient feels compelled to do despite knowing it is irrational

Question 25

pseudo-hallucinations

Answer 25

a hallucination that the patient knows is not real

Question 26

hallucination

Answer 26

a sensory perception (visual, auditory, smell) without an external stimulus

Question 27

what is psychosis

Answer 27

a syndrome of symptoms causing someone to lose touch with reality

disrupted beliefs- delusion
disrupted perception- hallucination
disrupted thought- thought disorder

Question 28

examples of delusions

Answer 28

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