Psychiatric history and MSE Flashcards

1
Q

4 aims of psychiatric assessment?

A

Gathers sufficient info to make a diagnosis + establish care plan
Communicate w other health prof. + Create safe environment to interview patient in
Communicate with patient + informants
Systematically record info + feedback to patient & their families

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2
Q

Outline the psychiatric history which is UNIQUE

A

unique to Psychiatric History:

Personal History- inc forensic history
Past Psychiatric History
Pre Morbid Personality

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3
Q

5 things asked during history of presenting complaint?

A

“When did you last feel completely well?” - define the current episode in terms of time (Chronological order)
Onset, duration & changes over time
Predisposing & relieving factors
Life events, drug misuse or non-compliance with prescriptions
Suicidal thoughts + actions must be asked in every patient assessed!

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4
Q

What is asked in Personal History? What must you pay attention to?

A

try to get Chronological picture of patient’s life - pay attention to the events that may’ve affected their:

  • Psychological development
  • Capacity to form + maintain relationships
  • Their view of themselves + world

Eg- early trauma, relationships, education, sexual etc

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5
Q

3 things explored during past psych history?

A

Admissions with understanding of context, incl. use of mental health act
Previous Treatments & compliance to them
Episodes of self-harm

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6
Q

What would you explore during alcohol + drug use history if the patient is using?

A

For each drug - ask physical health + social consequences (relationships, finances, police),
Method of administration, risks
Ask prev treatments for addiction, inc detox
Periods of abstinence
Motivation to reduce or stop use?

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7
Q

What is meant by pre morbid personality?

A

Collateral history
Patient’s/loved ones view of what they were like before current problem

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8
Q

What does the mental state examination entail?

AbSMTPCI

A

Appearance and behaviour
Speech- how loud, fast, tone, spontaneity
Mood
Thought – content and form
Perceptions
Cognition
Insight

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9
Q

Expand on mood in the mental state examination using subjective and objective

A

Subjective is the patient’s own view of his current mood
Objective is how he appears to the assessing clinician

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10
Q

What is meant by non-psychotic thought content?
What are delusions?

A

Non-psychotic thought content: phobias, ruminations, obsessions with understanding of compulsions

Delusions: fixed false beliefs that cannot be changed by opposing evidence + are not in line w cultural backgrounds

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11
Q

What is meant by abnormal thought content?

A

Abnormal thought content involves:
thought withdrawal/broadcast/insertion
somatic passivity, delusional misinterpretations

Thought withdrawal = delusional belief that thoughts have been ‘taken out’ of the patient’s mind, and the patient has no power over this.

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12
Q

Thought encompasses content and form. What is meant by thought form?

A

checking for presence of thought disorder based on patients form & content of speech

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13
Q

3 things classified as abnormal experiences?

A

Auditory, visual, olfactory, gustatory, sensory or tactile hallucinations
derealisation or deja vu
Depersonalisation, awareness of disturbance in thinking or actions!

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14
Q

Explain insight + 3 ways to examine insight

A

An assessment of the extent of agreement between patient + Dr.

ways to break up insight:
Does the patient believe they have a problem?
Does the patient understand their problem?
Are they willing to accept treatment?

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15
Q

What type of questions should you ask when trying to gauge risk assessment?

A

How serious is risk?
Is risk specific or general?
Is risk immediate or volatile?
What specific treatment & management plan can best reduce the risk?

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