Intro to Psych

Question 1

What percentage of patients in primary care practices come due to psychiatric problems?

Answer 1

• 30%

Question 2

What percentage of people who kill themselves see their doctor in the month before they die?

Answer 2

>50%

Question 3

How do behavior and social factors exert actions on the brain?

Answer 3

Learning produces alterations in gene expression

• Alterations in gene expression induced by learning give rise to changes in patterns of neural connections

Question 4

Why is psychotherapy effective?

Answer 4

It alters our gene expression by learning new ways to think/cope.

Question 5

What are the 8 questions we need to memorize for a psychiatric interview?

i.e. - 8 areas of inquiry

Answer 5

1. Why is the patient here now (and not last week)?
2. Hx of psychiatric illness?
3. Medical problem causing difficulty with mood/thinking?
4. Potential for lethal behaviors?
5. What does the pt want/expect from you?
6. Family/friends – problem or solution?
7. Cultural expectations, explanations & self-treatments?
8. Pt’s characteristic ways of dealing with stress/people?

Question 6

What are the 3 parts of a a 3-part 30min interview?

Answer 6

1. Engage
   
   • Patient tells story, clarify hx by summarizing & tracking
   • Begin to organize data into 8 areas of inquiry
2. Assess
   
   • Test & refine clinical hypothesis
3. Focus
   
   • Focus on what you judge to be relevant at this time
   • Decide on what can wait

Question 7

Is the Mental Status Exam (MSE) subjective or objective?

Answer 7

MSE: key part of objective evaluation

• Like a physical exam of patients feelings, thinking, and behavior

Question 8

What are the 10 parts of a mental status exam?

**I don’t think you need to memorize but rather recognize**

Answer 8

1. Appearance - grooming/clothing
2. Behavior - Cooperative/Agitated/Slowed
3. Speech - Rate/pressured
4. Mood - pervasive/sustained emotion (in pt’s words)
5. Affect - Observed emotion (Flat/Depressed)
6. Thought proccess - linear/logical/circumstantial/tangential
7. Thoght content - Obsessions/Suicide/Delusions
8. Insight - Understanding of current state
9. Judgement - decision making (poor/fair/good)
10. Cognition - MMSE score if done, AO x3