Mental state exam

Question 1

Menomic for mental state exam

Answer 1

ASEPTIC
Appearance
Speech
Emotion
Perceptions
Thoughts
Insights
Cognition

Question 2

What is the mental state exam?

Answer 2

Examination of patients mental state at the time you see them

Question 3

Why do the mental state exam?

Answer 3

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

Question 4

Typical rapport, appearance and behaviour in schixophrenia

Answer 4

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.

Question 5

What is akathisia?

Answer 5

Inner restlessness -> inability to sit still

Question 6

Typical appearance, rapport and behaviour in mania

Answer 6

bright clothes (extravagant), revealing clothes, heavy make-up, agitation, overfriendly/overfamiliar, intense eye contact (or poor), rapport difficult to establish, distracted.

Question 7

Depression typical behaviour appearnace and rapport

Answer 7

dishevelled, neglected, evidence of weight loss, sloughed posture, withdrawn, tearful, psychomotor retardation, poor eye contact

Question 8

Appearance, rapport and behaviour typical of anxiety

Answer 8

anxious, fidgety, well kempt, distracted at times, rapport easily established, pleasant and cooperative.

Question 9

Dementia typical appearcnace, behaviour and rapport

Answer 9

dishevelled, mismatched clothes, distracted, uncooperative, distracted, forgetful, agitated at times

Question 10

Personality disorder rapport, behaviour and appearance typically

Answer 10

uncooperative, using foul language, evidence of self-harm, rapport difficult to establish

Question 11

How does speech change in schizophrenia?

Answer 11

Normal rate + volume
Monotonous

Question 12

Typical talking pattern in mania

Answer 12

Pressured speech, loud, normal tone

Question 13

Typical speech in depression

Answer 13

Slow, monotonous, low volume

Question 14

Typical speech in anxiety, dementia and personality disorder

Answer 14

Normal rate vol and tone

Question 15

Schizophrenic typical mood

Answer 15

subjectively “ok”, objectively appears euthymic / depressed, with blunted, incongruent affect

Question 16

Manic typical mood

Answer 16

subjectively “on top of the world”, objectively elated, labile incongruent affect

Question 17

Depression typicla mood

Answer 17

subjectively “low”, objectively depressed (mild / moderate / severe) with flat affect

Question 18

Anxiety typical mood

Answer 18

subjectively “fine”/”low”, objectively euthymic / depressed and anxious, congruent affect

Question 19

Dementia typical mood

Answer 19

subjectively difficult to elicit, objectively euthymic / depressed / elated. Incongruent or congruent affect

Question 20

Personality disorder typical mood

Answer 20

subjectively “shit / crap”, objectively euthymic with congruent / incongruent affect

Question 21

Schizophrenia - typical though tpattern

Answer 21

delusions present (persecution, bizarre, reference, control…); formal thought disorder evident (derailment, tangentiality, loosening of associations, neologism, clang association), thought block, poverty of thought.

Question 22

Manic thought typical pattern

Answer 22

delusion of grandeur; flight of ideas, pressured thought, circumstantiality.

Question 23

Depression thought typical pattern

Answer 23

nihilistic delusion, excessive guilt, hopelessness, helplessness, worthlessness; poverty of thought.

Question 24

Anxiety thought typical pattenr

Answer 24

phobia present (simple, social, agoraphobia), no formal thought disorder evident.

Question 25

Hallucinations in schizophrenia

Answer 25

auditory hallucinations present (2nd person / 3rd person, thought echo, running commentary, commending). Reported/observed.

Question 26

What would be noticed about hallucinations in personality disorder?

Answer 26

hallucinations reported (quality: pseudo hallucination), none evident

Question 27

Cognitive impairment in depression vs mani

Answer 27

Depression - poor concentration
Mania - unable to focus on tasks
May be impaired in schizophrenia

Question 28

Dementia cognitive impairment

Answer 28

needs to be formally assessed, cognitive impairment present (poor orientation, poor memory, poor attention, poor concentration,

Question 29

Which mental health conditions lack insight?

Answer 29

Schizophrenia, mania

Question 30

Which conditions have partial insight>

Answer 30

Dementia, personality disorder

Question 31

Which conditions have full insight

Answer 31

Depression and anxiety