Mental State Examination Flashcards

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1
Q

how do you test concentration/attention

A

say months of the year backwards

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2
Q

what is mental state examination the equivalent to in general medicine

A

physical examination

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3
Q

what is the difference between mood and affect

A

mood - subjective at time of interview - how to they say they are feeling

affect - what do you observe, do they look happy/sad etc. eg. how does their mood appear to you

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4
Q

true or false: mood is constantly changing

A

false
mood usually stays the same

affect changes all the time. People look unhappy when you talk about a sad subject, or look happy when u talk about something happy eg. face lights up, affect gets brighter

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5
Q

what is reactivity

A

how much the affect can vary

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6
Q

what is euthymic affect

A

normal/fine affect

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7
Q

what is a flattened/blunted affect

A

when the affect doesn’t vary much

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8
Q

what is an unreactive affect

A

when the affect doesn’t change

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9
Q

what is incongruent affect

A

opposite affect eg. when talking about something happy they look sad/ when talking about something sad they look happy

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10
Q

what is a perception without stimulus

A

hallucination

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11
Q

what is an illusion

A

a misperception of a REAL stimulus eg. thinking nurses shoes are ferrets lol

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12
Q

what is passivity

A

things that are normally under the patients control but when unwell are not under their control

eg. though broadcasting - feelings like you don’t have control of your thoughts eg. other people can access your thoughts, take them away, here them etc

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13
Q

what is a persecutory delusion

A

belief that you are being persecuted, with no real evidence

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14
Q

what is insight

A

self awareness in relation to the illness - do they know they have an illness

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15
Q

what is looked at in a mental state examination

A
Appearance and behaviour 
Speech 
Affect and mood 
Thoughts: control&content 
perception 
cognition 
insight
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16
Q

what to look for in behaviour

A
eye contact 
rapport 
open/guarded/suspicious 
agitation/psychomotor retardation 
disinhibition/overfamiliarity
17
Q

what to look for in speech

A
rate 
amount 
variation in tone 
speech delay 
volume
18
Q

what to look for in mood

A

subjective
how does the patient feel today (currently not over past few weeks)

response is usually “fine, tired, down, worried, pretty good’ etc

19
Q

what to look for in affect

A

objective assessment - how the patient appears through the interview

what is the baseline affect eg. low, anxious, elated - and to what extent it varies eg. appropriately reactive, labile unreactive, flattened, blunted, incongruent

20
Q

how to asses cognitive function

A

look at orientation to time, place and person

asses concentration

asses memory

21
Q

how to determine a patient’s insight

A

do they recognise they re unwell?

do they attribute it to a mental health problem?

do they accept the need for treatment? hospitalisation?

22
Q

when are hallucinations significant

A

in context of other relative symptoms- can otherwise be induced in most people eg. by sensory deprivation

23
Q

what are types of auditory hallucination

A

Second person - voices directly address the patient
Third person - voices discuss the patient or provide a running commentary on his actions
Though echo - the patient experiences his own thoughts spoken or repeated out loud

24
Q

what are somatic hallucinations

A

bodily sensations eg. insects crawling under skin or being touched

25
Q

what are visual hallucinations

A

hallucinations associated with altered consciousness/organic impairment

simple. eg- flashes of light
complex eg. face or figure

26
Q

what other sensory hallucinations can you have

A

olfactory

gustatory

27
Q

what is the passivity phenomena

A

when behaviour is experienced as being controlled by an external agency rather than by the individual

28
Q

what can passivity affect

A

thoughts
-though insertion, withdrawal, broadcasting

actions - made actions

feelings - made feelings

29
Q

where are brain abnormalities seen in the passivity phenomena

A

in the parietal and cingulate cortices which are involved in interpretation of sensory information

30
Q

what is a thought disorder

A

disorder of the form of thought - an abnormality in the way their thoughts are linked together.

2 types:
flight of ideas
loosening of associations

31
Q

what is a flight of ideas thought disorder

A

words are associated together inappropriately because of their meaning or rhyme so that speech then looses its name and the patient wanders far from the topic of conversation

jump from topic to topic but with recognisable links such as rhyming, punning or environmental distractions

32
Q

what is loosening of associations thought disorder

A

patient’s speech is muddled, illogical and difficult to follow and cannot be clarified

speak so vaguely that no information is given in spite of the number of words used

33
Q

what is neologism thought disorder

A

an abnormality of speech in which the patient makes up a new word or phrase or uses existing words or phrases in bizarre ways with no accepted meaning

34
Q

what is a delusion

A

false belief firmly held in the face of logical argument or evidence to the contrary

not modified by experience or reason

usually very individualised or of great personal significance

35
Q

how are delusions identified

A

by their form, but described by its content or theme

‘not what you believe, how you believe it’

36
Q

what is the theme of a delusion

A

in general terms, what it is about

37
Q

where do delusions originate from

A

from an attempt to explain anomalous experiences eg. hallucinations, passivity experiences, depression