Mental State Examination Flashcards
how do you test concentration/attention
say months of the year backwards
what is mental state examination the equivalent to in general medicine
physical examination
what is the difference between mood and affect
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
true or false: mood is constantly changing
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
what is reactivity
how much the affect can vary
what is euthymic affect
normal/fine affect
what is a flattened/blunted affect
when the affect doesn’t vary much
what is an unreactive affect
when the affect doesn’t change
what is incongruent affect
opposite affect eg. when talking about something happy they look sad/ when talking about something sad they look happy
what is a perception without stimulus
hallucination
what is an illusion
a misperception of a REAL stimulus eg. thinking nurses shoes are ferrets lol
what is passivity
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
what is a persecutory delusion
belief that you are being persecuted, with no real evidence
what is insight
self awareness in relation to the illness - do they know they have an illness
what is looked at in a mental state examination
Appearance and behaviour Speech Affect and mood Thoughts: control&content perception cognition insight
what to look for in behaviour
eye contact rapport open/guarded/suspicious agitation/psychomotor retardation disinhibition/overfamiliarity
what to look for in speech
rate amount variation in tone speech delay volume
what to look for in mood
subjective
how does the patient feel today (currently not over past few weeks)
response is usually “fine, tired, down, worried, pretty good’ etc
what to look for in affect
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
how to asses cognitive function
look at orientation to time, place and person
asses concentration
asses memory
how to determine a patient’s insight
do they recognise they re unwell?
do they attribute it to a mental health problem?
do they accept the need for treatment? hospitalisation?
when are hallucinations significant
in context of other relative symptoms- can otherwise be induced in most people eg. by sensory deprivation
what are types of auditory hallucination
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
what are somatic hallucinations
bodily sensations eg. insects crawling under skin or being touched
what are visual hallucinations
hallucinations associated with altered consciousness/organic impairment
simple. eg- flashes of light
complex eg. face or figure
what other sensory hallucinations can you have
olfactory
gustatory
what is the passivity phenomena
when behaviour is experienced as being controlled by an external agency rather than by the individual
what can passivity affect
thoughts
-though insertion, withdrawal, broadcasting
actions - made actions
feelings - made feelings
where are brain abnormalities seen in the passivity phenomena
in the parietal and cingulate cortices which are involved in interpretation of sensory information
what is a thought disorder
disorder of the form of thought - an abnormality in the way their thoughts are linked together.
2 types:
flight of ideas
loosening of associations
what is a flight of ideas thought disorder
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
what is loosening of associations thought disorder
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
what is neologism thought disorder
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
what is a delusion
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
how are delusions identified
by their form, but described by its content or theme
‘not what you believe, how you believe it’
what is the theme of a delusion
in general terms, what it is about
where do delusions originate from
from an attempt to explain anomalous experiences eg. hallucinations, passivity experiences, depression
