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Psych Unit 1 > 1 Psychiatric Interviews and Mental Status Interview > Flashcards

1 Psychiatric Interviews and Mental Status Interview Flashcards

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1
Q

_______% of all patients are diagnostic or sub-clinical for psychiatri illness but only ____% of all patients consult for psychiatric reasons

A

30-40%

~5%

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2
Q

The majority of patients ultimately diagnosed with ADHD initially presented to ___________.

A

Primary care or pediatrics

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3
Q

In deciding whether to refer a patient to psych, what is the most important question to ask yourself?

A

Could this patient cause harm (to themselves or to others)?

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4
Q

The 12 domains of the mental status exam are used to describe…

A

The patient’s current state of mind

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5
Q

The mental status exam is the basis for…

A

Dx (DSM criteria), psychiatric formulation, and treatment plan

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6
Q

What are the 12 domains of the mental status exam?

A 
Appearance
Alertness/orientation
Speech
Motor behavior
Mood and Affect
Attention
Memory
Perception
Insight
Judgement 
Thought content
Thought processes
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7
Q

Name the domain…

Grooming/clothing
Skin lesions, body mods
Habitus or physique

A

Appearance

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8
Q

Name the domain…

“Patient attended interview well kempt and appropriately dressed”

A

Appearance

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9
Q

Name the domain…

“Patient arrived to the appointment disheveled and in dirty clothes”

A

Appearance

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10
Q

Name the domain…

Assessing a patient’s level of consciousness, alertness, or state of awareness of the environment

A

Alertness and Orietation

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11
Q

Name the domain…

“Patient is A&O x 4”

A

Alertness and Orientation

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12
Q

What does the 4 stand for in “A&Ox4”?

A

Person
Place
Time
Situation

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13
Q

If a patient is disoriented, it’s typically NOT a …

A

Not a psych issue

Could be delirium, dementia, neurological problem, schizophrenia…

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14
Q

Name the domain…

Observing spontaneous speech and language tests

A

Speech

But it’s speech PRODUCTION, not CONTENT

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15
Q

When observing a patient’s speech, you are interested in speech ________, not speech _______.

A

Speech production, not content

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16
Q

When observing a patient’s speech, consider…

A

Rate

Volume

Type
• Slurred
• Mumbled
• Aphasia
• Word salad
• Clang assoc
• Neologisms
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17
Q

Speech is, by and large, fluent, but it may appear to not make sense to listeners, as the patients themselves cannot understand what they are saying.

A

Wernicke’s aphasia

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18
Q

Name the domain…

“Patient was observed ambulatory without evidence of psychomotor retardation or agitation”

A

Motor Behavior

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19
Q

Name the domain…

“Patient exhibited several akathisia”

A

Motor Behavior

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20
Q

Examples of different types of motor behaviors

A 
Hyperactive
Hypoactive (psychomotor retardation)
Rigid
Restless/akathisia
Combative
Tics
Eye contact
Gait

Note - many motor behaviors can be medically induced

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21
Q

Name the domain…

Sustained emotion that affects a person’s view of the world

A

Mood

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22
Q

Name the domain…

Patient’s subjective description of his or her emotional state in his or her own words

A

Mood

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23
Q

Name the domain…

“She described herself as depressed, which caused her great frustration”

A

Mood

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24
Q

Descriptors for the mood domain

A 
Depressed, sad
Irritable
Anxious
Angry
Euphoric
Apathetic
Futile
Frightened
Guilty
Normal
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25
Name the domain... Emotion conveyed via non-verbals
Affect
26
Name the domain... An observable feeling or tone expressed through voice, facial expression, and demeanor
Affect Described by CLINICIAN, not the patient (that’s mood)
27
Descriptors for Affect domain
``` Normal/full Blunted, flat, constricted Exaggerated Labeled Appropriate/inappropriate (to the conversation) ```
28
Name the domain... The ability to focus or concentrate over time on one task or activity
Attention/attitude
29
Name the domain... Patient’s rapport, approach to interview
Attention/attitude
30
Name the domain... The process of registering or recording info
Memory
31
Childhood recollections are considered ______ memory
Remote
32
Current events within the past few months are considered _______ memory
Recent remote
33
Recalling what you had for breakfast is considered ______ memory
Recent
34
The word list recall or repeating a phone number back is a test of ______ memory
Immediate retention and recall
35
The 6-digit test is an assessment of _______ but is also a _______ test
Immediate retention and recall Attention test
36
Name the domain... Sensory awareness of objects in the environment and their interrelationships
Perception Also refers to internal stimuli
37
False sensory perception NOT associated with REAL external stimuli
Hallucinations
38
Examples of different types of hallucinations
``` Auditory Visual (think drugs) Olfactory Tactile (think meth) Gustatory ```
39
What is the most common type of hallucination?
Auditory
40
Misperception or misinterpretation of REAL external stimuli
Illusions
41
A person’s subjective sense of being unreal, strange, or unfamiliar
Depersonalization | Think schizophrenia
42
A subjective sense that the environment is strange or unreal
Derealization
43
The feeling of bugs crawling on or under the skin
Formication Think meth or other psycho-stimulants
44
Name the domain... Patient’s awareness that Sx or disturbed behaviors are normal or abnormal
Insight
45
Name the domain... Patient’s understanding of his/her illness
Insight | Can complicate consent for treatment
46
Name the domain... Is a continuum over several encounters
Insight 1. Recognition they may have mental illness 2. Compliance with treatment plan 3. Re-label false mental events
47
Which type of mental illness is most commonly associated with poor insight?
Personality disorders
48
Name the domain... Process of comparing and evaluating alternatives when deciding on a course of action
Judgement
49
Name the domain... Can they make sound, reasonable, responsible decisions? How would they respond in real-life challenges?
Judgement
50
Name the domain... “If you found a stamped, addressed envelope lying on the street, what would you do with it?”
Judgement
51
Name the domain... WHAT the patient thinks about and the focus of their concerns
Thought content
52
Name the domain... Extent to which the patient believe’s their thoughts/conviction
Thought content
53
Fixed, false, personal beliefs that are not shared by other members of the person’s culture Cannot be corrected by reasoning
Delusions
54
What are the different types of delusion?
``` Paranoid Grandeur Nihilistic Ideas of reference Ideas of influence Persecution ```
55
Recurrent, uncontrollable THOUGHTS, images, or impulses
Obsessions They are not false thoughts, but they are prominent
56
Repetitive BEHAVIORS or mental acts that a person feels driven to perform
Thought content
57
Persistent, irrational, exaggerated fear of a specific stimulus or situation (but pt knows it’s irrational)
Phobias
58
_______ can be accompanied by a compelling desire to avoid a stimulus
Phobias
59
Name the domain... Quantity, tempo, and coherence of a patient’s thought
Thought processes
60
Name the domain... The logic, coherence, and relevance of the patient’s thought as it leads to selected goals
Thought processes HOW a patient thinks
61
Examples of different types of thought processes to document...
``` Rapid thinking Slow or hesitant thinking Goal-directed thinking Relevant responses Loose associations, flight of ideas Tangential, circumstantial Perseveration Blocking ```
62
______ is the basis to formulate any psychiatric diagnosis ______ is a brief neuropsychological test to screen for dementia
MSE (Mental Status Exam) MMSE (Mini-Mental Status Exam)

Psych Unit 1 (6 decks)

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