Initial Work-up Flashcards
DSM-5 no longer uses the axis system, instead the _____ dx is listed first, and the ______ dx follows.
DSM-5 reorganized to reflect the _____ of disorders
If a medical problem is responsible for the mental illness, what is listed first?
Principal/major dx is usually listed 1st, minor dx follows
developmental timeline
The medical dx goes 1st
The DSM-5 is a Reference manual w/ very specific dx criteria depending solely upon _____ of specific illnesses
S/S characteristic
Aides in ___ between conditions due to its specificity.
It does NOT have any recommendations regarding ___, nor any recommended ____ or other tx
DDx
Rx therapy
therapy choices
The DSM-5 provides info on a condition’s ___, ____, ___, ____, many other important factors
Prevalence
Development/course
Risk/prognosis
suicide risk
Boundaries between disorder categories are ___over the life course and sx assigned to one d/o may occur in many other d/o
fluid
Many mental d/o are on a ___ w/ related d/o that have shared ___
spectrum
sx
D/o are organized on ___ and ___ considerations
developmental
lifespan
Important Hx questions to ask
Changes in mood sleep problems crying episodes excessive worry difficulty concentrating trouble at work/school change in appetite memory/relationship problems
___ sxs are more specific hx of onset, frequency, exacerbations and relief
Positive
It is important to consider correlations w/ new ___, ___, ____, ____
meds
life events
drug use
menstrual cycle
____: Evidence of anhedonia [inability to feel pleasure]; depressed or irritable mood
You can use ___ to screen for this.
Depression
“SIGECAPS”
____: Distractible, risky behaviors, grand ideas, poor sleep (extreme, i.e. x2 days)
You can use ____ to screen for this
Mania
“DIGFAST”
___ is described as Panic attacks, perseverative thoughts/paranoia, repetitive behaviors, obsessive cleaning or orderly behaviors, traumatic events w/ assoc. dreams/night terrors, panic
Anxiety
____ is described as Blunted/unexpressive affect, disorganized speech, hallucinations, delusions (based on something real, but misinterpreted/invented) → usually, psychosis is very easy to detect
Psychosis
What does “SIGECAPS” stand for?
Sleep Interest Guilt Energy Concentration Appetite Psycho-motor retardation/agitation Suicide
What does DIGFAST Stand for?
Distractibility Insomnia Grandiosity Flight of ideas Activities Speech Thoughtlessness
What is a syndrome?
Collection of sx, tending to occur together, often w/ a predictable course and outcome
In the psychiatric interview, Dx are mostly based on what?
The history!
The Mental Status Exam gives you insight to a person’s ___ and ____
Thought process
Thought content
____ are the Themes that occupy pts thoughts/perceptual disturbances
Spontaneously expressed worries, thoughts, concerns, SI/HI, phobias
Delusions, hallucinations, illusions, depersonalization
Thought content:
_____ is the Formation/coherence of thoughts; inferred through pt’s speech and expression of ideas
Are they vague? Incoherent? Flight of ideas or loose associations?
Do they perseverate [repeat or prolong an action, thought, or utterance after the stimulus that prompted it has ceased]? Thought blocking?
Thought process:
What is included in the w/u for psychiatric emergencies?
assessing if Pt ia a danger to self or others?
The need for dx testing for a medical illness?
communicating with Current tx providers and Family who can give helpful info
Social, environmental, cultural factors relevant to immediate tx decisions
Can pt actively participate in tx?
Specific follow up plan
When are times that someone can be place under a Mental Health Hold
Someone called police w/ concerns of pt’s safety
Friend/family brings pt to hospital w/ concerns for safety
Intoxication, substance abuse, agitation, depression
ED must ‘____’ a pt exhibiting signs of mental illness
medically clear
