Psychiatry Flashcards
What to include in a psychiatric history?
- Referral
- PC
- HPC inc. exploration of associated symptoms
- Past psych history
- PMH
- Meds
- Family history
- Personal history
- Social history (DRUGS AND ALCO, inc. finances)
- Forensic history
- Premorbid personality
What are the 8 steps included in a Mental State Examination?
- Appearance
- Behaviour
- Mood/affect
- Speech
- Thought
- Perception
- Cognition
- Insight
What is the difference between mood and affect?
Mood is the sustained emotion present over a long period of time
Affect is the immediately expressed and observed emotion.
Can think of mood as climate and affect as the weather.
Define blunting of affect
A severe reduction in emotional expressiom.
Complete lack of emotion is defined by a _____ affect?
Flat
During the mental state examination cognition is examined. What 3 factors contribute to cognition?
a) Orientation (in time/place/person)
b) Concentration/ attention
c) Short term memory
What is the difference between thought form and thought content?
Thought form - Speed and coherence of the thought processes. Any possession?
Thought content - Abnormal beliefs/ delusions, obsessions, overvalued ideas, suicidal thoughts, violent thought (harm to self or others)
Insight is not a binary - can be divided into 3 classes, what are they?
- Aware of an abnormal experience
- Aware of an abnormal experience as a result of a disease process
- Open to intervention (highest level being that they are aware of the risks of non compliance, use of psychoactive substances and their impact on others)
What are the 5 main aspects of a risk assessment?
- Risk of harm to self
- Risk of harm to others (physical, emotional, safeguarding)
- Accidental harm to self
- Self-neglect
- Vulnerability to exploitation
Define an illusion
An illusion is a misperception of a real external stimulus.
Define a hallucination
A hallucination is a perception in the absence of an external stimulus
Give 5 modalities of hallucinations
- Auditory
- Visual
- Olfactory
- Gustatory
- Tactile
- Somatic
What are the two terms given to hallucinations experienced..
a) When falling asleep
b) When waking up?
a) Hypnopompic
b) Hypnogogic
Hypnopompic or hypnogogic hallucinations are experienced by what percentage of the population?
10%
Define a reflex hallucination
A hallucination in one modality that is provoked by a stimulus in another modality. Eg. when you write I can hear your pen pressing on my heart