PSYC: Introduction to Psychological Medicine/Behavioural Science; Parasuicide & Depression

Question 1

What are the seven components of the mental state exam?

Answer 1

• Appearance & Behaviour.
• Talk.
• Mood & Affect.
• Thought.
• Perception.
• Cognitive State Examination.
• Insight & Judgement.

Question 2

• Define suicide (4 components).
• Define parasuicide.
• Define deliberate self harm.

Answer 2

1. A death.
2. Achieved by the individual that died.
3. Intentional.
4. Involving an active (commission) or passive (omission) agent.

• Active example: taking tablets.
• Passive example: not drinking water for days.

PARASUICIDE

• Behavioural analogues of suicide.
• Self-harm, unsuccessful suicide, and similar conditions.

DELIBERATE SELF HARM

• Subset of parasuicide.
• Overt intent to cause harm to one’s self (usually physical).

Question 3

• What are the ten risk factors that lead to suicide?
• Highest risk factor in immediate suicide.

Answer 3

1. Sex.
2. Age.
3. Depression.
4. Previous attempt.
5. Ethanol abuse.
6. Rational thinking loss.
7. Social support problems.
8. Organised plan.
9. No spouse.
10. Sickness.

• Medical students/doctors.

Question 4

What are the DSM 5 criteria for a major depressive disorder?

Answer 4

[FOR PAST TWO WEEKS] At least five of the criteria below including at least one of:

1. Depressed mood most of the day nearly every day (subjective report or observation).
2. Anhedonia - loss of pleasure and enjoyment for normal activities, most of the day nearly every day.

OTHERS:

1. Weight loss/gain or increased/decreased appetite nearly every day.
2. Insomnia or hypersomnia nearly every day.
3. Psychomotor agitation/retardation nearly every day (observed by others, not subjective).
4. Fatigue or loss of energy nearly every day.
5. Feelings of worthlessness or excessive/inappropriate guilt nearly every day.
6. Diminished ability to think or concentrate nearly every day (subjective, or observed by others).
7. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, suicide attempt, or a specific plan for committing suicide.

NOTES

• These represent a change from previous functioning.
• Symptoms that are clearly attributable to another medical condition shouldn’t be included.

Question 5

What are the seven components of the psychiatric interview?

Answer 5

1. History.
2. MSE.
3. Formulation.
4. Diagnosis and differential diagnosis.
5. Management plan.