T10.5: Psych Interview & Mental Status Exam

Question 1

You are evaluating your patient via mental status exam. When he first enters the room he is very cheerful and enthusiastic. However, after 10 minutes, he seems bored and disinterested in being there, and starts giving rude answers to your questions. Describe his affect. (MG)

A. Labile
B. Flat
C. Suspicious
D. Broad

Answer 1

A. Labile

Emotions fluctuating throughout the interview is called labile

Question 2

Differentiate between tangential and derailed (MG)

Answer 2

Tangential is wandering thoughts/responses with a logical connection. Ex. You ask him if he has been sleeping well and he tells you about a dream he had.

Derailed is wandering thoughts/responses with no logical connection to each other. Ex. You ask him if he has been sleeping well and he starts talking about how much he loves disco dancing.

Question 3

You are evaluating your patient via mental status exam. When you ask her about how she has been sleeping lately, she seems distracted and distressed. She doesn’t answer your question and instead looks around nervously saying “Oh my god…. what if my husband finds out I’m here?” Describe her thought content (MG)

A. Obsessive
B. Ruminative
C. Delusional
D. Flailing

Answer 3

B. Ruminative: preoccupation with distressing memories, thoughts, or worries

In this case, the patient is preoccupied by her worries of her husband finding out she is at the doctor - so much that she can’t focus on your conversation or answer questions. This is common in domestic abuse cases.