Symptoms of the Mind Flashcards
what is the difference between neurological conditions and psychiatric conditions
- Neurological conditions are as a result of disturbance of brain function and can cause symptoms of impairment or motor or sensory system
- Psychiatric conditions - these are disturbances of brain function with symptoms of altered thinking and behaviour
what is mental health defined as
Mental health is not defined as just an absence of mental disorder, but a a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community
What is important in history taking in psychiatry
• Background info
• Hx of Presenting complaint
• Family history including psych hx
• Personal history
– Birth and early development – traumatic brain injury if they have had a traumatic birth, early development – learn to walk, talk, fine motor skills and reading at the right time or did they need extra health or have an extra tutor, when they think back to there childhood what do they think about it
– Family background and early childhood
– Education – how far they got, did they have frineds at school, did the education lead to occupation
– Occupation- what work have they done since then
– Psychosexual/relationships – want to understand the quality of relationships that they have had, the duration of the relationship
What other things would you look for in a history taking in psychiatry
- Past psychiatric hx
- Past medical hx
- Current medication
- Substance misuse – what substances, when did they start
- Forensic history
- Current social circumstances – environment that they live in, struggling financially, homelessness
- Premorbid personality- attitudes, beliefs, prevalent mood, fantasies, coping with stress, how would they describe there personality before they became ill, or how there friends would describe the,
- Collateral history –
How do medical progressions standardise description of signs and symptoms
Record observations so that someone else can understand patient’s presentation
Provide snapshot using the MSE (Mental status examination) as situation is ever changing
Verbatim quotes (exact repetition without changing the words)
What are the symptoms of a mental disorder versus normal stress
- For the individual it is distressing, it effects their function, it is severe enough to be noticed, goes on for longer, might be out of context or an extreme reaction to something
- Distressing (to the person or those around them)
- Affect functioning
- Severe
- Longer in duration
- Out of context
- Outside of socio-cultural norms
name the different sections of the mental state examination
- Appearance
- behaviour
- speech and the form of thought
- mood
- though content
- cognition
- insight
- other psychotic symptoms
- perceptions
describe the different sections of the mental state examination
Appearance (age, sex, ethnicity, appropriateness of dress and self care, anything unusual, signs of emotion, affect - external expression of emotion, mood on face)
Behaviour (appropriateness of interaction, rapport, friendliness/hostility, eye contact, movements, postures)
Speech and the form of thought (rate, rhythm, volume, spontaneity)
Mood (Subjective & Objective, ability to enjoy things, sleep, appetite, libido, energy, negative/positive thoughts, self esteem,) + RISK (hopes and future plans, suicidal thoughts or thoughts of harming others).
Thought content (delusions - paranoid, religious, worries/anxieties, preoccupations/obsessions, signs of thought interference, or passivity
Cognition (orientation in time/ place/ person, attention/concentration, comment on intellectual ability (IQ testing), memory (MMSE, frontal lobe test)
Insight (patients ideas about their condition and illness, health beliefs, attitudes to treatment/medication/talking therapy)
Other psychotic symptoms (thought interference - like in schizophrenia
Perceptions (illusions - false perception of real external stimulus e.g. seeing person in curtains, Hallucinations - false perception in the absence of any real stimulus (can be in any sensory modality).
What do you assess in a risk assessment in the mood section of the mental state examination
– Hopes and future plans
– Suicidal thoughts or thoughts of harming others – doesn’t increased the likelihood, if you don’t ask the question than you are missing the point of asking about someone’s mood and the presentation of that day
what is passivity phenomena
- person doesn’t feel in control of their thoughts or actions
– feelings or actions experienced as made or influenced by external agents
– might feel as if they are made to do things by something else
name 4 types of psychoses
- schizophrenia
- drug induced psychosis
- puerperal psychosis
- delusional disorder
describe the 4 types of psychoses
Schizophrenia - thought echo, insertion, withdrawal or broadcast, delusions of control of the body (thoughts, actions or sensations), delusional perception, hallucinatory voices commenting or discussing, persistent delusional beliefs, negative thoughts
Drug induced psychosis
Puerperal psychosis - postpartum psychosis, woman with onset of symptoms following childbirth
Delusional disorder - patients present with delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect.
what are affective disorders
Affective disorders are a set of psychiatric diseases, also called mood disorders.
name the three types of major affective disorders
- depression
- bipolar disorder
- anxiety disorder
(also mania)
what are the symptoms of depression
Low mood Anhedonia (can’t get enjoyment out of things) Low energy Poor concentration Low self esteem Guilt and unworthiness Hopeless, pessimistic views on life (DSH - Deliberate self-harm) Poor sleep - EMW (early morning waking) Diurnal variation in mood Psychomotor retardation or agitation (slowing of physical and emotional reactions, including speech and affect) Appetite and weight change Low libido
