History taking and examination Flashcards
why is it important to ask about premorbid personality
to get a gauge of what youre aiming to restore
advantages to classify psychiatric conditions
effective communication and diagnosis
predictive power
incidence/prevalence
guidance of treatment
disadvantages to classify psychiatric conditions
oversimplified
overdiagnosed
labelling stigma
discounts possible cultural explanations
important childhood considerations in hx
bullying?
social connection
abuse?
academic achievement
important considerations in SHx
smoking stress past relationships risky behaviour premorbid personality religion relationship with alcohol finance
considerations and questions to ask when evaluating suicidal tendencies
concrete plans method node thoughts intention premeditation
screening factors in depression
low mood low motivation low energy and fatigue change in appetite/sleep poor concentration
1st rank features of schizophrenia
3rd person auditory hallucination delusions of thought delusion of control delusion of perception somatic hallucination
what is thought withdrawal
thougths being taken awayy
what is thought insertion
agency adding thoughts
waht is thought broadcasting
everyone hears your thoughts
what is a delusion of control
someone is controlloing you
what is a delusion of perception
giving meaning to something specific
components of appearance on MSE
age, sex, race body habitus grooming attire posture hand gesture movement and gait smell
components of behaviour on MSE
eye contact rapport open/guarded/suspicious agitation/psychomotor retardation disinhibition
components of speech on MSE
rate amount tone delay volume
components of insight on MSE
does the patient know they are unwell? do they attribute this to a mental health issue
do they accept the neex for tx
components of affect/mood on MSE
mood is subjective and is how the patient feels
affect is an observation of how the patient appears through examination, objective
components of cognitive function on MSE
orientation to time, place, person - date, time, where they are, name, DOB, age
concentration - months backwards
memory - autobiographical, anterograde, retrograde
what is a hallucination
perception in absence of external stimuli
types of hallucination
auditory - 2nd/3rd person visual olfactory gustatory somatic
what is passivity phenomena
behaviour controlled as external agency rather than by individual
thought insertion/withdrawal/broadcasting
what is flight of ideas
words used inappropriately due to meaning or rhyme so patient wanders, jumping topic to topic with distraction, rhyme or pun
what is loosening of word association
muddled, illogical speech and hard to follow
patient talks freely but so vaguely that no information is given
what is neologism
patient makes up new words/phrases in bizarre ways but are idiosyncratic to pt
knights move thinking?
patient jumps from topic to topic with no connection at all
what is a delusion
false belief or belief held on false grounds
great personal significance but cannot be explained or modified by reason
theme of delusion in mania
religion, persecution, grandiosity
theme of delusion in schizophrenia
control, persecution, reference, love, religion
theme of delusion in depression
nihilistic, sin, guilt, disease, poverty
