Mental state examination Flashcards
7 categories of mental state examination
Appearance and behaviour Speech Mood Thoughts Perceptions Cognition Insight
Things to look for in appearance and behaviour
Eye contact Rapport Self care Dress Psychomotor agitation Abnormal movements Distract-ability Perplexity Cooperation
Things to look for in speech
Production not content
- rate
- rhyme
- tone
- volume
- mutism
- neurological/ organic signs
Things to look for in mood
Subjective (patient view)
Objective (your assessment)
Affect
What does affect mean
immediate emotion
What does mood mean
Emotion over a more prolonged period of time
Objective assessment of mood
Euthymic
Depressed or elated
Irritable
Anxious
Affect assessment
Reactive, flat or blunted, incongruent
What is the pressure type of thoughts: stream
Unusually rapid, abundant and varied
What is the poverty type of thoughts: stream
Unusually slow, few and unvaried
What is the thought blocking type of thoughts: stream
The mind is suddenly empty of thoughts
What is the flight of ideas type of thoughts: form
Thoughts are moving so quickly that one train of thought is not completed before the next one starts
What is the loosening of associations type of thoughts: form
Lack of logical connection between a sequence of thoughts- knights move thinking
What is the preservation thoughts: form
Persistent and inappropriate repetition of the same thought
What is an incongruent affect
Mood doesnt match what theyre talking about
What is a delusion
A false, unshakeable idea of belief that is firmly held despite evidence to the contrary that is not consistent with the persons educational, cultural and social background
What is the persecutory type of thoughts: delusions
People or organisations trying to inflict harm
What is the delusions of reference type of thoughts: delusions
Objects, events or people have special significance to that infdividual
What is the grandiose type of thoughts: delusions
Beliefs of exaggerated self importance
What is guilt or worthlessness type of thoughts: delusions
Beliefs that the person has done something shameful based on an innocent error
What is delusions of control type of thoughts:delusions
Beliefs that actions, impulses and thoughts are controlled by an outside agency
What is the delusions concerning the possession of thoughts type of thoughts: delusions
Thought insertion (by an external agency)\ Thought withdrawal (taken away) Thought broadcast (thoughts known to others)
Over-valued thoughts
Isolated, preoccupying and strongly held belief that dominates a persons life or actions
Obsessive thoughts
Recurrent and persistent thoughts, images or impulse s that occur despite efforts to exclude the,. They are their own thoughts and usually cause distress
Dissociative symptoms
Derealisation
Depersonalisation
Illusions
Define derealisation
Feeling the world is not real
Define depersonalisation
Feeling detached from yourself and emotions
Define illusions
Misinterpretation of an external stimulus in the context of emotional state
Define hallucination
Perception without an external stimulus
four types of hallucination
Auditory
Visual
Tactile
Gustatory and olfactory
What are auditory hallucinations
Can be voices, noises or music.
- 2nd person (to them)
- 3rd person (about them)
- command (telling them to do something)
What are visual hallucinations
Can be images or flashes
What are tactile hallucinations
Superficial sensations or being touched
What are gustatory and olfactory hallucinations
Usually an unpleasant taste or smell
Define cognition
Referes to a persons current capacity to process information
What things contribute to cognition
LOC Orientation in time and space Memory functioning Literacy and arithmetic skills Visuospatial processing Attention and concentration Language
Cognition screening tools
Mini mental state examination
Abbreviated mental test
Montreal cognitive assessment
Define insight
The patients awareness and understanding of their mental illness
What are olfactory hallucinations associated with
Temporal lobe epilepsy
Physical assessment
Look for signs and symptoms
- may be exacerbating
- signs of mental disorder
- signs of associated physical health
Physical investigations
Detailed and focussed exam Physical obs Blood investigations ECG imaging
Non physical investigations
Collateral information
Review of clinical records
