Mental state exam Flashcards
Menomic for mental state exam
ASEPTIC
Appearance
Speech
Emotion
Perceptions
Thoughts
Insights
Cognition
What is the mental state exam?
Examination of patients mental state at the time you see them
Why do the mental state exam?
Obtain ecidence of symptoms and signs of mental disorders
Provides snapshot at point in time
Provides info for diagnosis, formulation and assessment of disorder + treatment/response to
Infrom risk assess process
Typical rapport, appearance and behaviour in schixophrenia
dishevelled, unkempt (dirty clothes, hair, malodourous), clothes inappropriate to the weather, mismatch (socks of different colours), expressionless face, akathisia, tardive dyskinesia, agitation, hostile, suspicious, non-cooperative, distractible, poor eye contact.
What is akathisia?
Inner restlessness -> inability to sit still
Typical appearance, rapport and behaviour in mania
bright clothes (extravagant), revealing clothes, heavy make-up, agitation, overfriendly/overfamiliar, intense eye contact (or poor), rapport difficult to establish, distracted.
Depression typical behaviour appearnace and rapport
dishevelled, neglected, evidence of weight loss, sloughed posture, withdrawn, tearful, psychomotor retardation, poor eye contact
Appearance, rapport and behaviour typical of anxiety
anxious, fidgety, well kempt, distracted at times, rapport easily established, pleasant and cooperative.
Dementia typical appearcnace, behaviour and rapport
dishevelled, mismatched clothes, distracted, uncooperative, distracted, forgetful, agitated at times
Personality disorder rapport, behaviour and appearance typically
uncooperative, using foul language, evidence of self-harm, rapport difficult to establish
How does speech change in schizophrenia?
Normal rate + volume
Monotonous
Typical talking pattern in mania
Pressured speech, loud, normal tone
Typical speech in depression
Slow, monotonous, low volume
Typical speech in anxiety, dementia and personality disorder
Normal rate vol and tone
Schizophrenic typical mood
subjectively “ok”, objectively appears euthymic / depressed, with blunted, incongruent affect
Manic typical mood
subjectively “on top of the world”, objectively elated, labile incongruent affect
Depression typicla mood
subjectively “low”, objectively depressed (mild / moderate / severe) with flat affect
Anxiety typical mood
subjectively “fine”/”low”, objectively euthymic / depressed and anxious, congruent affect
Dementia typical mood
subjectively difficult to elicit, objectively euthymic / depressed / elated. Incongruent or congruent affect
Personality disorder typical mood
subjectively “shit / crap”, objectively euthymic with congruent / incongruent affect
Schizophrenia - typical though tpattern
delusions present (persecution, bizarre, reference, control…); formal thought disorder evident (derailment, tangentiality, loosening of associations, neologism, clang association), thought block, poverty of thought.
Manic thought typical pattern
delusion of grandeur; flight of ideas, pressured thought, circumstantiality.
Depression thought typical pattern
nihilistic delusion, excessive guilt, hopelessness, helplessness, worthlessness; poverty of thought.
Anxiety thought typical pattenr
phobia present (simple, social, agoraphobia), no formal thought disorder evident.
Hallucinations in schizophrenia
auditory hallucinations present (2nd person / 3rd person, thought echo, running commentary, commending). Reported/observed.
What would be noticed about hallucinations in personality disorder?
hallucinations reported (quality: pseudo hallucination), none evident
Cognitive impairment in depression vs mani
Depression - poor concentration
Mania - unable to focus on tasks
May be impaired in schizophrenia
Dementia cognitive impairment
needs to be formally assessed, cognitive impairment present (poor orientation, poor memory, poor attention, poor concentration,
Which mental health conditions lack insight?
Schizophrenia, mania
Which conditions have partial insight>
Dementia, personality disorder
Which conditions have full insight
Depression and anxiety
