MSE & Psychiatric Interview Flashcards
Mental state exam features?
Appearance Behaviors Speech Affect Thought Perception Cognition Insight
Explain behaviour in MSE?
Gait General activity Movements/tics Facial expression Eye contact Limb movements Tearful/laughing
Speech and language description in MSE?
Volume
Prosody: speech rhythm
Pressure
Dysarthria
Language
Dysphasia
How is mood and affect evaluated? The content?
Quality (sad, suspicious, elated) Intensity (mild, moderate, severe) Range, reactivity Congruence Communication
Term for perplexity?
Bewildered
Puzzled
Occurs with serious thinking abnormality (organic/psychotic)
What is a fatuous affect?
- Vacant, silly, superficial
- Incongruent with thought/situation
- Think psychotic
Dynamics of affect?
How it changes during interview.
Restricted affect: eg. Depression, no different states
Commonly reduced in organic/psychotic and affective disorders
What is the reactivity in the affect?
How fast each affect state is changing
Lability - Rapid shift from sad to euphoric (mania)
Irritability - (mania), rapid into anger
‘Flatness’: restrictions of tone of an affect (depression)
What is a blunted affect? When see it commonly?
- Loss of emotionality or empathy for the event
- No bodily language for feeling states
Cardinal feature in Schizophrenia
What is congruence of affect?
What condition affects congruence?
Talk about sad things: feels sad
Affective disorders
What is communication of affect?
Picking up the feeling state of the patient by feeling it in yourself
What is the communication of affect in schizophrenia?
‘Pane of glass’, you feel nothing
Thought description in MSE?
Stream
Form
Content
Possession
Thought description in MSE for stream?
Slow
Fast
Pressured’ - manic
Increased latency
What is Form for Thought description in MSE?
connectivity of ideas
-logicality and understandability of connections between one thought and another.
What flight of ideas? See when?
Manic - rapid thinking
3 types of abnormalities of thought form with normal connections?
Flight of ideas
Retarted thinking
Circumstantiality
What is circumstantiality for thought form?
Talking around the point, takes a long time
Abnormalities of thought form with abnormal connections?
Tangentiality
Derailment: suddenly start talking about something else.
Blocking: stop halfway throughout idea
Word salad
Thought content What is overvalued ideas?
Preoccupies the patient
Strong emotional investment
Passionately held, amenable to some reason
Delusional thinking Thought content is?
- Fixed false belief
- Great personal significance
- Absolute conviction
- generally regarded as false by others
- out of keeping with education/cultural, social background
- emerge in pathological manner
- Can extend into other beliefs
What is a primary delusion?
Out of the blue (de-novo)
Irreducible
What are the 4 primary common delusion?
- Sudden autochthonous delusion
- Delusional atmosphere
- Delusional perception
- Delusional memory
What is a secondary delusion?
Delusion-like ideas
- Coming out of other events
- psychologically reducible
- can be possibly treated
Content delusions?
Bizarre vs. Non Bizarre
Persecution Passion - jealousy (can be deadly) Identity: grandeur Non-existence Somatic/hypochondriacal "illness" Reference
What is first rank auditory hallucination?
Hearing one’s thoughts out loud, running commentary, discussion in third person
Phenomenology?
Examine without presupposition but by pure description
