Psychiatry Flashcards

1
Q

What to include in a psychiatric history?

A
  1. Referral
  2. PC
  3. HPC inc. exploration of associated symptoms
  4. Past psych history
  5. PMH
  6. Meds
  7. Family history
  8. Personal history
  9. Social history (DRUGS AND ALCO, inc. finances)
  10. Forensic history
  11. Premorbid personality
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2
Q

What are the 8 steps included in a Mental State Examination?

A
  1. Appearance
  2. Behaviour
  3. Mood/affect
  4. Speech
  5. Thought
  6. Perception
  7. Cognition
  8. Insight
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3
Q

What is the difference between mood and affect?

A

Mood is the sustained emotion present over a long period of time

Affect is the immediately expressed and observed emotion.

Can think of mood as climate and affect as the weather.

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4
Q

Define blunting of affect

A

A severe reduction in emotional expressiom.

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5
Q

Complete lack of emotion is defined by a _____ affect?

A

Flat

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6
Q

During the mental state examination cognition is examined. What 3 factors contribute to cognition?

A

a) Orientation (in time/place/person)
b) Concentration/ attention
c) Short term memory

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7
Q

What is the difference between thought form and thought content?

A

Thought form - Speed and coherence of the thought processes. Any possession?

Thought content - Abnormal beliefs/ delusions, obsessions, overvalued ideas, suicidal thoughts, violent thought (harm to self or others)

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8
Q

Insight is not a binary - can be divided into 3 classes, what are they?

A
  1. Aware of an abnormal experience
  2. Aware of an abnormal experience as a result of a disease process
  3. Open to intervention (highest level being that they are aware of the risks of non compliance, use of psychoactive substances and their impact on others)
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9
Q

What are the 5 main aspects of a risk assessment?

A
  1. Risk of harm to self
  2. Risk of harm to others (physical, emotional, safeguarding)
  3. Accidental harm to self
  4. Self-neglect
  5. Vulnerability to exploitation
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10
Q

Define an illusion

A

An illusion is a misperception of a real external stimulus.

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11
Q

Define a hallucination

A

A hallucination is a perception in the absence of an external stimulus

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12
Q

Give 5 modalities of hallucinations

A
  1. Auditory
  2. Visual
  3. Olfactory
  4. Gustatory
  5. Tactile
  6. Somatic
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13
Q

What are the two terms given to hallucinations experienced..

a) When falling asleep
b) When waking up?

A

a) Hypnopompic

b) Hypnogogic

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14
Q

Hypnopompic or hypnogogic hallucinations are experienced by what percentage of the population?

A

10%

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15
Q

Define a reflex hallucination

A

A hallucination in one modality that is provoked by a stimulus in another modality. Eg. when you write I can hear your pen pressing on my heart

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16
Q

What is an extra-campine hallucination?

A

A hallucination that is considered outside of the normal sensory field or range.

Eg. Having the sensation of seeing something behind them
Having the sensation of hearing people in Australia talk

17
Q

What is the difference between a hallucination and a pseudo-hallucination?

A

Pseudo-hallucinations are hallucinations occurring in the subjective inner space of the mind, not through an external sensory organ, although they are not under conscious control.

Hallucinations are perceived through an external sensory organ.

18
Q

What is an overvalued idea?

A

A false or exaggerated belief sustained beyond logic or reason held with less conviction than a delusion; but also often less patently unbelievable

19
Q

What are the 5 factors associated with increased risk of completed suicide in a patient that has previously attempted suicide?

A
  1. Planning
  2. Efforts to avoid discovery
  3. Leaving a written note
  4. Final acts e.g. sorting out finance
  5. Violent method
20
Q

3 common protective factors that reduce the risk of patient committing suicide?

A
  1. Family support
  2. Children in house
  3. Religious belief
21
Q

Give 3 risk factors for increased risk of suicide

A
  1. Male sex
  2. Advancing age
  3. History of mental illness (depression, schizophrenia)
  4. History of chronic disease
  5. Unmarried/divorced/widowed
  6. Unemployed
  7. Living alone
  8. History of self harm
  9. Drug/alcohol abuse