Mental State Examination Flashcards
what do you note on appearance
distinguishing features - scars, tattoos
weight
stigmata - jaundice
personal hygiene
clothing - weather appropriate?
objects
what do you look for in behaviour
engagement
eye contact
facial expression
body language
what do you want to note in a patients speech
rate of speech
quantity of speech
tone
volume
fluency and rhythm
how do you determine thought form? what are you looking for
loose association - rapid movement from 1 topic to another without connection
circumstantial thought - irrelevant info
tangential - going off topic
flight of idea - excited speech which goes off topic
thought blocking - sudden stop
perseveration - repetition
clang association - rhyming
neologisms - made-up words
word salad - random words
poverty of speech - little content
what is an example of loosening of association
“I have choose right over wrong. When there are two options, I have to look to the right. I can choose left or right, but always look right.”
what is an example of circumstantial speech
When asked about the age of a person’s mother at death, the speaker responds by talking at length about accidents and how too many people die in accidents, then eventually says what the mother’s age was at death.
what is an example of flight of ideas
“I don’t know what I’m going to do about Tony. Well there’s the neighbor’s dog barking again. Did you realize there are three weeks left until June? Man it’s hot in here. There’s a sale down at the mall I just can’t miss.”
what is an example of perseveration
When is your birthday? - 1973
What is the year now? - 1973
What is your name? - 1973
Can you write down your phone number? - 1973333333333333333
what is an example of word salad speech
The sheep languished blue trains suffer.
Windows books dogs hands run.
Run desk making dinner sunglasses menu
what is a delusion
a firm, fixed belief based on inadequate grounds, not amenable to a rational argument or evidence to the contrary and not in sync with regional and cultural norms.
what is an obsession
thoughts, images or impulses that occur repeatedly and feel out of the person’s control. The patient is aware these obsessions are irrational, but the thoughts continue to enter their head
what is a compulsion
repetitive behaviours that the patient feels compelled to perform despite recognising the irrationality of the behaviour.
what is an overvalued idea
a solitary, abnormal belief that is neither delusional nor obsessional in nature, but which is preoccupying to the extent of dominating the sufferer’s life (e.g. the perception of being overweight in a patient with anorexia nervosa).
what other thought content should you want for
delusions
obsessions
compulsions
overvalued ideas
suicidal thoughts
homicidal/violent thoughts
hopelessness/ worthlessness
what kinds of delusions are there
Paranoid
Persecutory
Grandiose
Love
Jealousy
Somatic
Control/Thought possession
Reference
Guilt
Poverty
Cotard/Capgras/Fregoli
