1 - PSY - Hx, MSE + Management plan Flashcards
Things to know before taking a Psych Hx
Demographics
Mode of + reason for referral
If inpatient - are they under MHA
Headings of a PSY Hx
PC and HPC Past psych Hx FHx Medical Hx DHx Substance and Alcohol Hx Personal Hx Forensic Hx Premorbid personality Social circumstances
How is MSE unique?
focus on current state of mind
snapshot of behaviour and mental state at that point in time
you look for symptoms (subjective) and signs (objective)
Headings of an MSE
Appearance and behaviour Speech Mood and Affect Thoughts - Form and Content Perceptions Cognitive exam Insight
In appearance 4 parts?
clothes
weight
expression
posture
In behaviour 4 parts?
movements
social behaviour
rapport
eye contact
what is mood? 2 parts in MSE
pervasive and sustained emotional state - subjective and objective mood
Affect? 3 common description
behaviour ass w changing emotions such as fear sadness or joy - blunted/flattened, labile, inappropriate/incongruent affect
Thought form?
train of thought assessed through speech - (formal thought disorder)
Thought content psychopathologies?
over valued ideas, obsessions/ruminations, phobias, delusions
Perceptions - main three
sensory distortion (deperonalisation, derealisation)
illusion
hallucinations
Cognitive examinations - minimum screening for cog imp + name of more detailed test
Time place person
attention and concentration
memory
moca
Insight - 5 Qs
1 do you feel like there is anything wrong with you?
2 do you think this is due to an illness
3 is it a physical or mental illness
4 do you think this illness can be helped
5 will you accept help/treatment - including admission?
insight is present/partial/absent
What comes after Hx and MSE?
Physical examination
Ix - physical + psychosocial
Risk assessment
After Physical, Ix, and Risk?
Differentials/provisional Dx
MGMT plan - capacity, level of care + where, MHA?, Biopsychosocial approach, follow-up plan
