Mental State Examination Flashcards
Appearance
Normal - Well dressed and groomed
Abnormal - Unwell, poorly dressed, wasted, unwell, not appropriately dressed for environment or whether. State of self neglect, evidence of injury
Behaviour
Normal - Engaged with appropriate eye contact,
Abnormal - tremors, tics, and twitches. Suspiciousness, aggression or fear and catatonic features. EPSE. Retardation (slow, monotonous speech, slow or absent body movements). Agitation (inability to sit still, fidgeting, pacing or hand wringing, rubbing or scratching skin or clothes.
Attitude - toward you
Normal: Good eye contact and cooperative, cordial
Abnormal: uninterested, aggressive, defensive, guarded, suspicious, fearful, perplexed, preoccupied, dis inhibited eg being overly familiar or sexually inappropriate comments.
Speech
Rate of production - abn - pressure of speech in mania, long pauses and poverty of speech in depression
Quality and flow of speech - volume, dysarthria (articulation difficulties), dysprosody (unusual speech rhythm, melody, intonation or pitch) Stuttering.
Mood
Depressed, mania or emotional lability
Affect
Restricted, blunted, flat, I inappropriate, incongruous if mood and affect don’t match.
Derived from pt posture, facial expression, emotional reactivity and speech.
Perception
Hallucinations Pseudohallucinations Illusions Intrusive thoughts Which organ sense?
Thought
Delusion - Primary or secondary, mood congruent or incongruent, Bizarre or non bizarre. Content.
Disorganised thinking - circumstantial and tangential thinking, Loosening of association(derailment/knight move thinking) neologisms, and idiosyncratic word use, flight of ideas, thought blocking, perseveration, echolalia and irrelevant answers
Cognition
MMSE
Orientation, registration, attention, calculation, language, executive functioning and visuospartial skill
Insight
Normal - understand nature and degree of illness.
Abn - varying level of inadequate insight. Describe the level.
Define hallucination
Perceptions occurring in the absence of an external physical stimulus. They appear the same as a normal sensory experience to the pt and are one of the five sensory organs, and are not merely a distortion of an external stimulus
Define illusions
Misperceptions of real external stimuli. Eg the coat hanging up looks like a person in the dark.
Occur in normal people and are a result of inattention or strong emotion
Define pseudo hallucination
is a perceptual experience, which differs from hallucination in that t appears to arise in the subjective inner space of the mine not through on the external sensory organs. Eg seen though the inner eye. Distressing flashbacks in PTSD,
Somethings described as hallucinations that the patient recognises as false.
Frontal assessment Battery
Different frontal temporal dementia from Alzemler’s disease
