psychiatry Flashcards
mental state exam subheadings
appearance behavior speech mood thoughts beliefs percepts suicide/homicide cog function insight
MSE: appearance
height/build
clothing: approp, inapprop, kempt
personal hygeine: clean, unshaven, malodorous
MSE: behaviour
engagement and rapport
eye contact
gesturing: normal, expansive, bizare
psychomotor activity: retardation, fidgeting
abnormal movements: tremor, chorioathetoid movements
MSE: speech
rate: fast, slow
quantity: very little vs a lot
tone: monotonous
volume
fluency and rhythm: stammering, stuttered, slurred
pressure of speech
flight of ideas
slowed speech
psychomotor retardation - delayed response
minimal/absent speech
depression
excessive speech
mania
schizophrenia
MSE: mood
mood
affect
congruity of affect
psychomotor function: retarded, agitated
MSE: abnormal thoughts
thought form: speed, flow and coherence
thought content: delusions, obsessions, overvalued ideas
formal thought disorders
broadcast echo insertion block withdrawal
flow and coherence of thoughts
flight of ideas
thought blocking
neologisms
MSE: abnormal beleifs
preoccupations
delusional beliefs
overvalued ideas
MSE: abnormal precepts
illusions
hallucination
pseudo-hallucination
MSE: suicide/homicide
must ask about suicidal thoughts
ideation
intent
planning
MSE: cognitive function
orientated in time, place, person
attention + concentration
short and long term memory
if concerned: MMSE, MOCA, MSQ
MSE: insight
are symptoms due to illness
is it a mental illness
do you agree w Rx/Mx plan?
psychiatric history taking subheadings
presenting complaint systemic enquiry past psychiatric Hx PMHx medications FHx social history forensic history personal history + premorbid personality
psychiatric systemic enquiry
mood: depressed, euthymic, elevated anxiety/panic symptoms memory problems/confusion abnormal thought content: odd ideas, paranoia, obsessions perceptual abnormalities, hallucinations risk to self, others insight into illlness
past psychiatric history
prev episodes, diagnoses, contacts prev Rx: psychological, drugs, physical inter-episode functioning prev hosp admissions attempted suicide, DSH prev detensions
forensic history
contact w police? charged w a crime?
offences incl sentences
recidivism
psychiatric personal history
developmental milestones early life schooling relationships financial friendships, hobbies, interests premorbid personality
