L3: Psychiatric History & Mental State Examination Flashcards
How to approach a Psychiatric Patients?
Differences between Psychiatric interview & Medical Interview
History of Past Psychiatric & Medical History should include ……
- Chronological account of past psychiatric problems/episodes (if present)
- If the patient’s baseline of mental health was attained.
Items of History Taking in Psychiatry
History of Present Illness Should include ….
Developmental History
- Physical and intellectual ability at early stages of life.
- Life values, habits, goals before he/she becomes ill
what is mental state examination analogous to in internal medicine?
analogous to performing a physical examination in internal medicine.
Assessment of Speech
Assessment of appearence & Behaviour
Mental State Examination
what is Mood?
The emotion that the patient tells you he feels or is conveyed nonverbally.
What is Affect?
an assessment of how the patient’s mood appears to the examiner according to the following dimensions
Assessment of Affect
Examples of Assessment of Mood & Affect
Characters of Thought Process
- This is the patient’s form of thinking, how he or she uses language and puts ideas together.
- It describes whether the patient’s thoughts are logical, meaningful, and goal-directed.
- It does not comment on what the patient thinks, only how the patient expresses his or her thoughts.
Examples of disorders of thought process
what disorders of thought are common in schizophrenia?
Word salad and Neologism
Examples of disorders of Thought content
what disorders of thought are common in Mania?
Clang association, Flight of ideas loosening of associations
what are examples of delusions?
Assessment of Sensorium & Cognition
Def & Types of Hallucinations
- Sensory experiences not based in reality
- Canbe: visual, auditory, tactile, gustatory, olfactory, Vestibular
Def & Examples of Illusions
- Inaccurate perception of existing sensory stimuli
Example of illusion: Wall appears as if it’s moving
Clinical Examples of Assessment of Sensorium & Cognition
what is Insight?
- This is the patient’s level of awareness and understanding of his or her problem.
Types of problems in Insight
complete denial of illness or blaming it on something else.
Def of Judgment
- This is the patient’s ability to understand the outcome of his or her actions and use this awareness in decision making.
How to assess Judgment?
You can ask, “What would you do if you smelled smoke in a crowded theater?”
Diagnostic Aids in Psychiatry
- Mini Mental Status Examination (MMSE)
- Intelligence Tests
- Personality Assessment Tests
what is Mini Mental Status Examination (MMSE)?
It is a simple, brief test used to assess cognitive functioning.
Areas included in Mini Mental Status Examination (MMSE)
Charaters of Intelligence Tests
- When we want to assess patients mental health and intelligence.
- They are carried out by the psychologist.
Result of Mini Mental Status Examination (MMSE)
- The MMSE totals to 30 points, and a score of less than 24 implies cognitive impairment, which may suggest dement or delirium.
Types of Intelligence Tests
- Wechsler Adult Intelligence
- Scale Stanford-Binet Test (children)
How to Deal with a delusional Patient?
How to Deal With a Violent Patient?
Personality Assessment tests
How to Deal with a depressed Patient?
