Y4 - Anxiety and History Taking Flashcards
What important condition related to anxiety should be ruled out in the PMH?
Hyperthyroidism
What are the main sections of the mental state examination?
Appearance and behaviour Speech Mood Perception Thought Risk and suicidal ideation Cognition Insight
What points should be included within appearance during MSE?
Overall impression/description of looks
Physical condition
Suitability of dress
Cleanliness
What points should be included within behaviour on MSE?
Appropriateness of behaviour, e.g. overfamiliar, agitation, aggression
Distractibility
Abnormal normal involuntary movement
Rapport
What points should be included within speech on MSE?
Content
Form
What should be included within mood on MSE?
Subjective mood
Objective mood
Anxiety and panic symptoms
Obsessional thoughts (ruminations)
What is the difference between mood and affect?
Mood - someone’s emotional state over a long period
Affect - our emotional state at a certain point
What should be included within perception on MSE?
Hallucinations
Illusions
Disordered thinking
Delusions
What should be included within thought on MSE?
Formal thought disorder Delusions Over-valued ideas Preoccupations Obsessive thoughts, ideas or impulses
What should be included under risk and suicidal ideation on MSE?
Thoughts of suicide
Deliberate self harm
Harm to others
Intent, plan, lethality of plan, urge to act upon these, reasons for this, dangers to self or others
What should be included under cognition on MSE?
Alertness Attention and concentration Orientation to time place and person Short term memory Level of comprehension
What should be included under insight on MSE?
Do they recognise they are ill?
Do they think they are ill with a mental disorder?
Do they think they need treatment?
What is involved in GAD?
Excessive and uncontrollable worry
Motor tension, restlessness, irritability
Somatic symptoms, e.g. hyperventilation, tachycardia, sweating
How do you Rx GAD?
Applied relaxation, CBT, psychological/behavioural therapy
SSRI, SNRI, pregabalin
What is panic disorder?
Sudden, unpredictable episodes of severe anxiety
SoB, autonomic symptoms
Fear of dying/suffocation
Urgent desire to flee
