History & MSE Flashcards
1
Q
What questions would you like to ask about past psychiatric history?
A
- Any prev treatment / admissions to hospital for mental health
- Ever seen GP / counsellor about mental health
- Ever had symptoms & not seeked help?
- How did you respond to prev treatments? Was it helpful?
2
Q
What is involved in personal history?
A
- Infancy & early childhood
- Pregnancy (normal/problems)
- Any separation from family / hospitalisations
- Developmental delays?
- Who were they living with? Siblings
- Any major events?
- Adolescence & Education
- Where did they go to school?
- What was their experience?
- How did they fit in socially?
- How did they do academically
- Occupational record
- What jobs?
- Moving jobs a lot?
- Sexual development / relationships
- When was first?
- How many relationships?
- Quality of relationships
- Length of relationships
- Alcohol / drugs
- Use & degree of use
- Dependence
- When they use it
- Forensic
- Any criminiality
- Any convictions/prison sentences
3
Q
How do you ask about low mood?
A
- Open Qs
- How are you feeling in yourself?
- How have you been feeling
- Facilitating Qs
* Can you tell me more about that? - Focussed Qs
- Risk assessment
- Do you feel life is worth living?
- Has it ever gotten so bad that you’ve thought about harming yourself?
- What stops you from going through with it?
4
Q
How do you ask about delusions?
A
- Open questions
- Is there anything in particular on your mind
- Is there anything out of the ordinary going on>
- Are you worried about anything?
- Facilitating
* Can you tell me more about that? - Clarifying
- How do you know this is happening?
- When did you first notice it?
- Could there be any other explanation?
- Sometimes the mind can play tricks on you…
- Risks
* This sounds very frightening, have you taken steps to protect yourself / harm yourself
5
Q
How do you ask about disorders of though possession?
A
- Is anyone/anything interfering with your thoughts?
- Do you feel in control of your thoughts and actions
- Do you believe that you thoughts are your own?
Facilitating questions:
- Why do you say that?
- How can that happen?
- Tell me more about that
- Can you describe it?
6
Q
How do you ask about hallucinations?
A
- Open Qs
- Facilitating Qs
- Have you ever heard things you can’t explain?
- Have you ever heard noises when there is noone else around?
- Can you tell me more?
- Can you describe it?
- What is your explanation?
- How many voices & where do they come from?
- Risk assessment
- Do they ever tell you to do things?
- Are you able to resist them?
7
Q
What are the components of a Mental State Examination?
A
- Appearance & behaviour
- Speech
- Mood
- Subjective
- Objective
- Thought
- Form
- Content
- Perceptions
- Cognition
- Insight
8
Q
What do you assess within appearance & behaviour?
A
Describe pt:
- Well kempt? Unkempt? Clothing
- Body language
- Level of rapport
- Psychomotor agitation / retardation
- Distracted, responding to unseen stimuli
9
Q
What do you assess of the patient’s Speech?
A
- Rate, rhythm, volume / tone
- Any evidence of formal thought disorder?
10
Q
How do you assess Mood?
A
Subjective:
- How does pt describe their mood?
Objective
- Describe your view of pt’s mood
- Describe their affect (emotional responsiveness)
11
Q
How do you assess Thought?
A
- Form (of thought)
- Delusions
- Over-valued ideas
- Obsessive ruminations
- Obsessive intrusive thoughts
- Phobia
- Content (of thought)
12
Q
How do you assess Perception?
A
- Illusions
- Hallucinations
- Depersonalisation / Derealisation
13
Q
How do you assess cognition?
A
- Orientated to time, place & person?
14
Q
How do you assess Insight?
A
- Does pt believe they are unwell?
- Do they believe they have a mental disorder?
- What is their attitude to treatment?
15
Q
How do you assess Risk?
A
- Risk to self
- Self-harm
- Suicide
- Self-neglect
- Risk to health
- Worsening mental illness
- Deteriorating physical health
- Risk to others
- Paranoid delusions
- Command hallucinations
