Mental State Examination Flashcards

1
Q

Which disorders are included under anxiety?

A
  • Panic disorder
  • Agoraphobia
  • Specific phobias
  • GAD
  • OCD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the symptoms of panic disorder?

A
  • Recurrent panic attacks
  • Autonomic: palpitations, tremor, sweating, chest pain, nausea
  • Psychological: derealisation/depersonalisation, fear of losing control, dying
  • Not secondary
  • Persistent worry about another attack
  • Phobic avoidance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the symptoms of agoraphobia?

A
  • Anxiety + panic symptoms associated with places or situations
  • Avoidance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the symptoms of specific phobias?

A
  • Recurrent/excessive/unreasonable symptoms of anxiety - autonomic, psychological
  • Anticipated presence of specific feared object/activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the symptoms of GAD?

A
  • Excessive worry - generalised, free-floating, persistant anxiety
  • Apprehension about everyday events/persistent anxiety
  • Muscle + psychic tension
  • Significant distress/functional impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the symptoms of OCD?

A
  • Obsessions

- Compulsions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which disorders are included in mood disorders?

A
  • Depressive episode
  • Manic/hypomanic episode
  • Bipolar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the symptoms of depression?

A
  • Core symptoms: depressed mood, anergia, anhedonia
  • Biological symptoms - disturbed sleep, diminished appetite, reduced concentration
  • Psychological symptoms: reduced self esteem, self confidence, guilt/unworthiness, bleak view future, ideas/acts self harm/suicide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the ICD classification of depression?

A
  • Mild: 2 core + 2 others - not intense - 2w
  • Mod: 2 core + 3-1 others - intense
  • Severe: 3 core + 2 others - severe intensity - <2w +/- psychosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the symptoms of a manic episode?

A
  • Abnormally + persistently elevated/expansive/irritable mood with 3+ symptoms - 1w - sig impairment functioning
  • Increased energy (overactivity reduced sleep)
  • FTD (pressures speech, flight of ideas)
  • Reduced attention
  • Consequential behaviours (schemes, spending, sexual encounter)
  • Psychotic symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the symptoms of a hypomanic episode?

A
  • 3 + symptoms over 4 days
  • Not severe enough to interfere with social/occupational functioning, require admission to hospital, include psychotic features
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is bipolar affective disorder?

A
  • 2+ episodes (one which must be manic/hypomanic or mixed)

- Complete recovery between episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 2 classification of bipolar affective disorder?

A
  • BPAD 1 : mania + depressive episodes

- BPAD 2 : hypomania + depressive episodes (suicide more common as depressive episodes more severe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What disorders are included under psychotic disorders?

A
  • Schizophrenia

- Delusional disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the symptoms of schizophrenia?

A

At least 1 of:

  • thought echo/insertion/withdrawal/broadcast
  • delusions of control/passivity + delusional perception
  • auditory hallucinations (3rd person, running commentary)
  • implausible delusions

At least 2 of:

  • persistent hallucination with non-affective delusions
  • breaks in train or thought
  • catatonic behaviour
  • apathy/blunting
  • loss of interest/ social withdrawal

At least 1 month

Positive + negative symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the symptoms of delusional disorder?

A
  • Non-bizarre delusions
  • No hallucinations/ thought disorder/ mood disorder/ flattening of affect
  • Present for 1 m +
17
Q

What are some abnormalities of movement?

A
  • Agitation, retardation, stupor
  • Mannerisms vs stereotypy
  • Tics - motor vs vocal
  • Dystonia - spasm
  • Akathisia
  • Myoclonus
  • Chorea
18
Q

What do you assess in mental state examinations?

A
  • Appearance
  • Speech
  • Mood
  • Thoughts
  • Perceptions
  • Cognition
  • Insight
19
Q

How can you assess a patients speech?

A
  • Form vs content
  • Amount
  • Rate
  • Volume
  • Tone
  • Neologism
  • Logoclonia, echolalia, palilalia
20
Q

How can you assess a patients mood?

A
  • Mood (emotional state) - apathy
  • Affect (behaviour associated with changing emotions) - blunted, labile, emotional incontinence, incongruous affect
  • Climate vs weather
21
Q

How can you assess a patients thoughts?

A
  • Stream - pressure, poverty, thought block
  • Form - flight of ideas, loosening of associations, over-inclusive, circumstantiality vs tangentiality, derailment
  • Content - phobias, ruminations, obsessional thoughts
  • Delusions - fixed belief, primary, secondary, systematised
  • Main delusions - persecution, control, misidentification, grandeur, religion, guilt, nihilism, jealousy/love, somatic
  • Thought insertion/ withdrawal/ broadcast
  • Thought of harm to self or others
22
Q

How can you assess a patients perceptions?

A
  • Secondary distortion
  • Depersonalisation/derealisation
  • Illusion
  • Hallucination
  • Auditory
  • Visual - lilliputian, charles bonnet syndrome
  • Olfactory, gustatory, tactile
  • Hypnopompic/hypnogogic
  • Extra Campine = outside limits of sensory field - voices from Antarctica
  • Functional vs reflex
23
Q

How can you assess a patients cognition?

A
  • Orientation - time, place, person
  • Memory
  • Formal cognitive assessment
24
Q

How can you assess a patients insight?

A
  • Awareness if phenomena observed by others
  • Recognition of this as abnormal
  • Accepting cause = mental illness
  • Need for treatment