Mental state examination Flashcards
what are the sections of the mental state examination?
Appearance + Behaviour Speech Mood and affect Thought Perception Cognition Insight and Judgement
Why is the appearance important
may provide some clues as to their lifestyle and ability to self-care
things to look for in appearance
distinctive features clothing posture/gait grooming / hygiene evidence of self harm
what can a patients non verbal communication provide insight into?
their current mental state
things to look for in behaviour
eye contact faial expression psychomotor activity body language / gestures / mannerisms level of arousal - calm / agitated / aggression ability to follow requests rapport / engagement
things to look for in speech
rate, quantity tone volume fluency and rhythm
what is mood?
referes to a sustained state of the patients INNER feelings
what is affect?
refers to an OBSERVABLE EXPRESSION of a patients inner feelings
what questions could you ask about mood?
how are you feeling?
what is your current mood?
have you been feeling low/ depressed / anxious lately?
examples of various mood states
low/depressed anxious angry / irritable apathetic elated
what is the quality of the affect?
sad/agitated/ hostile?
euphoric / animated?
what is the range of affect?
restricted
normal
expansive
what is the intensity of the affect
normal
blunted
flat
fluctuations in affect can be described as…
labile - easily changed between states
how do you assess someones affect?
observe the patients facial expressions/ demeanour
what are the three descriptions of ones thoughts?
thought form
thought content
thought possession
what is thought form?
the form / structure of someones thoughts - the way the thoughts occur the speed of them and the flow / coherence of them
things to consider - thought form
speed - accelerated / racing / retarded
flow / coherence:
linear - in a logical order
incoherent - makes no logical sense
circumstantial - lots of irrelevant/ unnecessary details (not to the point)
tangential = patient moves from one thought to the other that relate in some way bu never gets to the point
flight of ideas - there is an increased number of ideas, produced at a rapid pace
perseveration - repetition of a particular response despite the absence / removal of the stimulus
what is thought content
what the patient is actual thinking about
the actual substance of the thought
if patient is thinking about walking their dog
it would be the walking the dog part
things to think about-
thought content
abnormal beliefs / delusions
Obsessions - patient is aware they are irrational, but obsessive thoughts continue to enter their head
Overvalued ideas - e.g. the perception of weight in a patient with anorexia nervosa
suicidal thought
homicidal/ violent thoughts
what is thought possession?
who owns the patients thoughts?
where do they come from
and where do they go?
things to think about -
thought possession
thought insertion - belief that thoughts can be put into the patients mind
thought withdrawal - belief that thoughts can be removed from patients mind
thought broadcasting - belief that others can ear the patients thoughts
what are three things to think about regarding patients perceptions?
hallucinations
pseudohallucinations
illusions
what is an hallucination?
a sensory perception without any external stimulation of relevant sense that the patient believes is real (e.g hears voices but no sound present)
