Mental State Flashcards
what are the areas of mental state exam
appearance, speech, thought form, mood and affect, disorders of thought content, perception, cognition, insight
what are you looking for in appearance
general health, posture, tattoos, piercings, injection sites, well kempt?, mannerisms, eye contact, rapport, abnormal movements- result of antipsychotics or tics, stereotypy, mannerisms, motor activity
what are you looking at in speech
tone, rate, volume
what is normal speech
spontaneous, relevant, logical, coherent
what is circumstantial speech
takes a long time to get to the point
what is perseveration (speech)
repeating of words or topics suggests frontal lobe dysfunction, schizophrenia, OCD
what is neologisms (speech)
made up words- can occur in schizophrenia
what are some abnormal forms of thought
flight of ideas (abnormal connection), loosening of associations (no discernible link, Knights move), thought block (subjective experience of thought is abnormal)
what happens in pressured speech (can occur in mania)
incr rate and volume
what happens to speech in depression
poverty of speech and thought block- decr tone, rate, vol
what is mood
patients underlying emotion report subjective mood and objective- euthymic, dysthymic, hyperthymic
what is affect
observed external manifestation of emotion. blunted (schizophrenia), labile, irritable, suspicious
what is labile
excessively changeable
what is incongruous (affect)
grossly out of tune with subjects being discussed eg laughing about bereavement
what is the affect described as if it is normal and no abnormality
reactive
what are some disorders of thought content
negative, ruminations, beliefs, delusions, phobias, obsessions, depersonalisation, derealisation, ideas of reference
what are ruminations
persistent, disabling preoccupations
what is depersonalisation
feeling detached, unreal
what is derealisation
feel like the world and people are lifeless
what are delusions
disorders of thought content. fixed, false beliefs out of keeping with culture
examples of delusions
grandiose, persecutory, of reference, thought insertion/withdrawal/broadcast, passivity
what are grandiose delusions
being famous, having supernatural powers, enormous wealth
what are persecutory delusions
someone interfering in a malicious way
what are delusions of reference
other people, media etc talking about you or communicating to you
thought withdrawal/insertion/broadcast
external someone controlling thoughts
passivity
actions, feelings being controlled by external
what can be abnormal perceptions
illusions, hallucinations, psuedohallucinations
what is an illusion
misintepretation of normal perception can occur in healthy people
what is a hallucination
perception in the absence of external stimulus
what is a pseudohallucination
internal perception with preserved insight
what are you testing in cognition
conciousness, memory, orientation, concentration, attention
what test can you do for cognition
Mini mental state examination (MMSE)
insight
understanding of condition, cause and willingness to accept treatment
what is echolalia
repeating another persons words
what is cotard delusion
believe dead already or dying, losing blood, organs etc
what is capgras delusion
delusion that friend, spouse etc have been replaced by identical looking imposter
what is couvade delusion
sympathetic pregnancy- husband gets symptoms of mothers pregnancy
what is Fregoli delusion
belief that friend, spouse is replaced by a twin imposter
what is Ekbom delusion
delusional parasitosis- psychosis
difference between primary and secondary delusion
primary- not understandable, fixed- capgras, cotard, etc etc. secondary can be understandable in mood context- persecution, grandiose etc
what is echo de la pensee
thought echo-voices heard within mind
in auditory hallucinations what should you differentiate
if it is a second person or a 2nd person talking to 3rd person
