Mental state examination

Question 1

7 categories of mental state examination

Answer 1

Appearance and behaviour
Speech
Mood
Thoughts
Perceptions
Cognition
Insight

Question 2

Things to look for in appearance and behaviour

Answer 2

Eye contact
Rapport
Self care
Dress
Psychomotor agitation
Abnormal movements
Distract-ability
Perplexity
Cooperation

Question 3

Things to look for in speech

Answer 3

Production not content

• rate
• rhyme
• tone
• volume
• mutism
• neurological/ organic signs

Question 4

Things to look for in mood

Answer 4

Subjective (patient view)
Objective (your assessment)
Affect

Question 5

What does affect mean

Answer 5

immediate emotion

Question 6

What does mood mean

Answer 6

Emotion over a more prolonged period of time

Question 7

Objective assessment of mood

Answer 7

Euthymic
Depressed or elated
Irritable
Anxious

Question 8

Affect assessment

Answer 8

Reactive, flat or blunted, incongruent

Question 9

What is the pressure type of thoughts: stream

Answer 9

Unusually rapid, abundant and varied

Question 10

What is the poverty type of thoughts: stream

Answer 10

Unusually slow, few and unvaried

Question 11

What is the thought blocking type of thoughts: stream

Answer 11

The mind is suddenly empty of thoughts

Question 12

What is the flight of ideas type of thoughts: form

Answer 12

Thoughts are moving so quickly that one train of thought is not completed before the next one starts

Question 13

What is the loosening of associations type of thoughts: form

Answer 13

Lack of logical connection between a sequence of thoughts- knights move thinking

Question 14

What is the preservation thoughts: form

Answer 14

Persistent and inappropriate repetition of the same thought

Question 15

What is an incongruent affect

Answer 15

Mood doesnt match what theyre talking about

Question 16

What is a delusion

Answer 16

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

Question 17

What is the persecutory type of thoughts: delusions

Answer 17

People or organisations trying to inflict harm

Question 18

What is the delusions of reference type of thoughts: delusions

Answer 18

Objects, events or people have special significance to that infdividual

Question 19

What is the grandiose type of thoughts: delusions

Answer 19

Beliefs of exaggerated self importance

Question 20

What is guilt or worthlessness type of thoughts: delusions

Answer 20

Beliefs that the person has done something shameful based on an innocent error

Question 21

What is delusions of control type of thoughts:delusions

Answer 21

Beliefs that actions, impulses and thoughts are controlled by an outside agency

Question 22

What is the delusions concerning the possession of thoughts type of thoughts: delusions

Answer 22

Thought insertion (by an external agency)\
Thought withdrawal (taken away)
Thought broadcast (thoughts known to others)

Question 23

Over-valued thoughts

Answer 23

Isolated, preoccupying and strongly held belief that dominates a persons life or actions

Question 24

Obsessive thoughts

Answer 24

Recurrent and persistent thoughts, images or impulse s that occur despite efforts to exclude the,. They are their own thoughts and usually cause distress

Question 25

Dissociative symptoms

Answer 25

Derealisation Depersonalisation Illusions

Question 26

Define derealisation

Answer 26

Feeling the world is not real

Question 27

Define depersonalisation

Answer 27

Feeling detached from yourself and emotions

Question 28

Define illusions

Answer 28

Misinterpretation of an external stimulus in the context of emotional state

Question 29

Define hallucination

Answer 29

Perception without an external stimulus

Question 30

four types of hallucination

Answer 30

Auditory Visual Tactile Gustatory and olfactory

Question 31

What are auditory hallucinations

Answer 31

Can be voices, noises or music. - 2nd person (to them) - 3rd person (about them) - command (telling them to do something)

Question 32

What are visual hallucinations

Answer 32

Can be images or flashes

Question 33

What are tactile hallucinations

Answer 33

Superficial sensations or being touched

Question 34

What are gustatory and olfactory hallucinations

Answer 34

Usually an unpleasant taste or smell

Question 35

Define cognition

Answer 35

Referes to a persons current capacity to process information

Question 36

What things contribute to cognition

Answer 36

``` LOC Orientation in time and space Memory functioning Literacy and arithmetic skills Visuospatial processing Attention and concentration Language ```

Question 37

Cognition screening tools

Answer 37

Mini mental state examination Abbreviated mental test Montreal cognitive assessment

Question 38

Define insight

Answer 38

The patients awareness and understanding of their mental illness

Question 39

What are olfactory hallucinations associated with

Answer 39

Temporal lobe epilepsy

Question 40

Physical assessment

Answer 40

Look for signs and symptoms - may be exacerbating - signs of mental disorder - signs of associated physical health

Question 41

Physical investigations

Answer 41

``` Detailed and focussed exam Physical obs Blood investigations ECG imaging ```

Question 42

Non physical investigations

Answer 42

Collateral information | Review of clinical records