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Psychology > Mental State Examination > Flashcards

Mental State Examination Flashcards

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1
Q

You expand the mental state examination according to the diagnosis you’re moving towards. Which area would you expand on with depression, schizophrenia, dementia?

A

Depression - mood
Schizophrenia - mood, abnormal beliefs and abnormal experiences
Dementia - mood, cognitive state

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2
Q

What are the 7 parts of a mental state examination?

A 
Appearance and behaviour
Speech
Mood
Thought content
Abnormal beliefs and experiences of events
Cognitive state
Insight
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3
Q

What are you looking for in the general appearance?

A

Signs of self neglect, poorly fitting clothes (indicating weight loss), inappropriate or very flamboyant clothes.

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4
Q

What are you looking for in facial appearance?

A

Downcast eyes, vertical furrow in brow, down turned mouth all indicate depression.
Fixed facial expression from Parkinson’s or Parkinsonism from antipsychotics.

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5
Q

What is echopraxia?

A

Seen in schizophrenia - automatic imitation of another’s movements.

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6
Q

What is posturing?

A

Seen in schizophrenia - adopting a bizarre posture for a long period of time.

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7
Q

What is a tic?

A

A repeated irregular movement involving any muscle group.

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8
Q

What posture is characteristic of depression?

A

Hunched shoulders and poor eye contact.

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9
Q

What is stupor?

A

The patient is conscious but mute and immobile.

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10
Q

What is the form of stupor seen in depression?

A

Depressive retardation (a lesser form of psychomotor retardation) which means a patient takes a long time to complete a movement.

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11
Q

What is obsessional slowness?

A

Seen in OCD, patient can’t get anything done because of the need to complete compulsive rituals.

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12
Q

What is it called when the patient shows unproductive restlessness?

A

Psychomotor agitation.

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13
Q

What is compulsion?

A

A repetitive, seemingly purposeful behaviour is carried out.

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14
Q

What three things are you assessing when looking at speech?

A

Rate - increased in mania, reduced in depression
Quantity - increased in mania and anxiety, reduced in dementia and schizophrenia and depression
Volume - shouting during normal conversation can indicate hypermania, depression leads to whispering

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15
Q

What is meant by increased pressure of speech?

A

Increased rate AND quantity of speech

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16
Q

What is meant by poverty of speech?

A

A restricted amount of speech

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17
Q

What is mutism?

A

The complete loss of speech

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18
Q

What is dysarthria?

A

Difficulty articulating speech

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19
Q

What is “flight of ideas”?

A

Thoughts are sped up so the person jumps form one topic to another.

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20
Q

What is a neologism?

A

When a patient uses a new word they’ve made up, or uses an everyday word in a way that only has meaning to them.

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21
Q

What is echolalia?

A

Patient automatically imitating another person’s speech

22
Q

What is thought blocking and what is it a sign of?

A

A sudden interruption to the train of thought so the patient can’t remember what they were thinking or saying and their sentence just trails off.
It is a sign of psychosis.

23
Q

What is Knight’s Move Thinking?

A

Odd associations between ideas leading to disruptions in the continuity of speech.

24
Q

What is a thought disorder?

A

Pattern of disordered language presumed to reflect disordered thinking.

25
Q

What is psychosis?

A

When a person loses contact with reality.

26
Q

What is mood?

A

Pervasive and sustained emotion which markedly colours the patient’s perception of the world.

27
Q

What two assessments of mood do you need to carry out?

A

Objective - based on history, appearance, behaviour and posture of the patient
Subjective - described by the patient, what they say they are feeling at the time

28
Q

What is a dysphoric mood?

A

Unpleasant mood where the person doesn’t feel comfortable.

29
Q

What is anhedonia?

A

A loss of ability and interest in regular and pleasurable activities.

30
Q

What are the biological symptoms that it is important to ask about to a depressed patient?

A

Weight loss, sleep pattern, appetite, constipation

31
Q

What is elation?

A

Elevated mood or exaggerated feeling of wellbeing.

32
Q

What is euphoria?

A

Personal feeling of unconcern and contentment.

33
Q

What is an irritable mood?

A

A tendency to be annoyed or provoked to anger.

34
Q

What is the difference between phobic anxiety and free-floating anxiety?

A

Phobic anxiety means the focus of the anxiety has to be avoided. Free-floating anxiety is pervasive and unfocused, and so the situation causing anxiety can’t be avoided.

35
Q

What is the patient’s affect?

A

How patient’s convey their mood by their behaviour.

36
Q

What are two different types of affects?

A

Inappropriate affect e.g appearing cheerful when talking about bereavement
Flat affect - absence of signs of expression of affect

37
Q

What is hypochondriasis an example of?

A

A preoccupation

38
Q

What four things are you looking for when assessing thought content?

A

Preoccupations
Obsessions
Phobias
Suicidal and homicidal thoughts

39
Q

What are overvalued ideas?

A

An unreasonable and sustained intense preoccupation, but with less than delusional intensity.

40
Q

What are delusions?

A

Fixed, false, personal beliefs which are firmly sustained in spite of obvious evidence to the contrary.

41
Q

What are a few different types of delusions?

A

Persecutory - someone trying to harm you
Delusions of reference - tv and radio is referring to you
Delusions of grandeur
Delusions of doubles - person has been replaced by a double
Nihilistic - denies they have a body, so refuses to eat
Somatic - sensory delusions
Erotomania - think someone’s in love with you

42
Q

What is the difference between a primary delusion and a secondary delusion?

A

A primary delusion arises fully formed without any discernible connection with previous events, but a secondary delusion arises when a person is trying to make sense of their experiences.

43
Q

What is passivity phenomena, and what are the three types?

A

A delusion that an external agency is controlling you by putting thoughts in your head.
Thought insertion = putting thoughts in your mind
Thought withdrawal = taking thoughts out of your mind
Thought broadcasting = reading your thoughts

44
Q

What is delusional perception?

A

When a patient attaches delusional significance to a real perception with no logical significance.

45
Q

What is the difference between an illusion and hallucination?

A

An illusion is a false perception in response to a real external stimulus, a hallucination is a false sensory perception in the absence of a real external stimulus.

46
Q

What types of hallucinations are there?

A 
Auditory (second person derogatory hallucinations in depression, third person running commentaries in schizophrenia)
Visual
Olfactory
Gustatory
Somatic
47
Q

What is pareidolia?

A

Vivid imagery occurring without conscious effort while looking at a poorly constructed background e.g a fire

48
Q

What is depersonalisation?

A

The patient feels they are not real.

49
Q

What is derealisation?

A

The person’s surroundings don’t feel real.

50
Q

What 4 things should you assess in cognitive state?

A

Orientation
Attention and concentration
Memory
General knowledge

51
Q

What is the max score of a mini mental state exam, and what 5 things are assessed?

A 
Max score = 30
Orientation
Registration
Attention and calculation
Recall
Language and praxis
52
Q

Why is insight important?

A

It’s important for compliance to treatment.

Psychology (8 decks)

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