Mental state examination

Question 1

define the mental state examination

Answer 1

used in every patient consultation in psychiatry
and psych patients in ED

Question 2

how does a hisotry and mental state examination differ

Answer 2

hisotry
-records ptx experience of syx UP TO the time of interview

MSE
-descibre the behaviour and syx AT THE TIME. of the interview

Question 3

purpose of mental state examination

Answer 3

evalutte if ptx has psych problem
-if so how severe
-what are the risks
-do they meet criteria for emergency detention

Question 4

first component of mental state examination

Answer 4

appearance and behaviour

Question 5

aspects of appearance and behaviour of mental state examination 5

Answer 5

well/kempt/scruffy

eye contact- yes or no

reactive to stimuli

figeting/appera nervous or distracted

responding to unseen stimuli

Question 6

aspects of speech for mental state examination 5

Answer 6

how much
-too little- (poverty)

making sense

volume

rate

rhythm

Question 7

aspects of mood for mental state examination 2

Answer 7

mood
-defined as emotional tone prevailing ar any given time

affect
-meaning a short-lived feeling state

Question 8

examples of speech syx 6

Answer 8

alogia-poverty of speech

dysarthria

stuttering

logoclinia- repeates last syllable

mutism

pressure of speech (or pressure of thought)

Question 9

examples of mood and affect syx 5

Answer 9

depressed mood

elevated mood

reactive affect

flattened or blunted affect

anxiety

Question 10

two important ways to assess risk behaviours in a mental state examination

Answer 10

for suicide:
-Sometimes when people feel low in mood, they might feel life is not worth living. Do you feel like that? Do you ever self harm?

for mania:
-When your mood is high, do you ever spend a lot of money, have unprotected sex, drink excessively…..

Question 11

what to ask in a mood history 3

Answer 11

rate mood 0-10

better or worse at particular time of day

periods of elated/depressed mood

Question 12

examples of thought form 4

Answer 12

word salad-a mixture of words or phrases that is confused and difficult to understand:

disjointed; tangential

rambling

knights move thinking

Question 13

examples of thought content

Answer 13

overvalued ideas

obessions

delusions

suicidal

thought withdrawal, insertion, broadcasting,

thoughts of reference

Question 14

difference between knights move thinking and flight of ideas

Answer 14

Flight of thought – this is where the patient moves quickly from one idea to another, often half-way through a sentence, with no apparent association between ideas. Knight’s move thinking (aka Derailment)- patient moves from one idea to another with strage illogical associations between the ideas.

Question 15

deinfe a delusion

Answer 15

fixed (usually) flase or fantasic idea

held in face of evidence to the contrary
and
out of keeping with the patients social milieu

Question 16

4 criteria for a delusion

Answer 16

held unshakably

not modified by experience or reason

content often bizarre

can be found in any psychotic presentation

Question 17

define ideas of reference as a form of thought contnetn

Answer 17

ambiguous events in outside world whose interpretations are without foundation wholly or mainly self-centred

Question 18

define overvauled idea

Answer 18

idea which in itself may be comprehensible or socially acceptable

but which has come to dominate the patients life and is pursed beyond bounds of reason

Question 19

some types of delusison and overvalued ideas

Answer 19

persecution

reference

dysmorphobobia

jealous

love

guilt, unworhtiness, poverty

gradniosity

Question 20

define an obession and compulsiosn

Answer 20

obsession- refers to impulses and thougths

Compulsion- confined to motor acts

Question 21

important characterisitc of obessions and complulsions

Answer 21

thought of carrying out act is not in itself pleasurable
-simple relief of anxiety or tension is no pleasurable

thouths, images and impulses must be unpleasantly repetitive

NO PLEAUSRE OR ENJOYMENT

Question 22

aspects of perception in mental state exam 3

Answer 22

hallucinations

pseudo-hallucinaitinos

illusions

Question 23

define hallucinations

Answer 23

false perception which is not in any way a distortion of a real perception

Question 24

criteria for hallucinations 3

Answer 24

unwilled and not subject to conscious manipulation

has the same qualities of a real perception
-ie vivd and solid

perceived as being located in external world

Question 25

two categories for halluciantions 2

Answer 25

auditory

visual

Question 26

auditory types of hallucinations 3

Answer 26

simple- sounds

complex- voices

musicle- (brain/ear disease)

Question 27

visual types of hallucinations 3

Answer 27

simple (flashses of light)
-ORGANIC DISEASE

complex- objects, animals, people

panoramic/experiental -ORGANIC DISEASE

Question 28

define pseudohallucinations

Answer 28

’ voice inside my head ‘
-‘i know its not real’

Question 29

how gets pseudohallucinations 5

Answer 29

depression

obsessional states

hysteria

personality disorder

times of life crisis eg bereavment

Question 30

aspects of cognition in a mental state exam 5

Answer 30

alterness

orientation

attention

memory

(time place person)

Question 31

define cognitive function

Answer 31

sum of all the patients higher mental functions
-how did the patient cope with the interview

do they have history of poor function

Question 32

define insight

Answer 32

correct attidue to morbid changes in oneself

Question 33

types of insight 3

Answer 33

1-awarenes of disease

2-correct labelling of abnormality

3- willingness to take treatment