Mental health: History and symptoms

Question 1

[Insert a joke]

Answer 1

Mental health isn’t a joke

Question 2

What is the structure of a mental health history?

Answer 2

PC
HPC 
Past Psychiatric/ medical history 
Medications and allergies - illicit drugs, alcohol, OTC
FH - inc. personal history 
SH 
Forensic history 
Premorbid personality 
Informant history

Question 3

What to include in a HPC?

Answer 3

Detail each symptom
Chronological account
Important +/-ve symptoms

Question 4

What to ask in HPC if there are voices?

Answer 4

Detail of voice - content, number 2/3 person, commanding

Hallucinations in other modalities - visual, tactile, olfactory, gustatory

Question 5

What to include in a past psychiatric history?

Answer 5

Episodes or continuous 
Admissions 
Diagnosis and treatment 
Mental health act
Deliberate self harm 
Contact with services

Question 6

What to ask about alcohol in medication history?

Answer 6

CAGE only for screening 
calculate units, routine etc.
Dependency - physical or mental harm 
Priorities - bills, other activities 
Withdraw

Question 7

What Illicit substances to ask about specifically?

Answer 7

Cannabis 
Amphetamines 
Heroin 
Crack/ cocaine 
LSD/Ecstacy 
Mushrooms 
Novel psychoactive substances

Question 8

What to ask in a family history?

Answer 8

Alive/ Dead
Quality of relationships
FH of psychiatric conditions

Question 9

What to ask in personal history?

Answer 9

Birth
Childhood milestones 
Abuse 
School 
Employment

Question 10

What to ask in the forensic history?

Answer 10

Any contact with courts/police

Violence or thoughts of violence

Question 11

What to ask about premorbid personality?

Answer 11

Describe themselves
Strengths and weaknesses
Hobbies and interests
Activity and socialisation

Question 12

What are the sections of the mental state examinations?

Answer 12

A Speedy Mental Test Putting Crazies Inside

Appearance and behaviour 
Speech 
Mood and affect 
Thought 
Cognition 
Insight

Question 13

What is waxy flexibility?

Answer 13

A form of catatonia in which tendency to remain in an abnormal posture - schizophrenia

Question 14

What is negativitism?

Answer 14

A form of catatonia in which there is increased resistance to movement - schizophrenia

Question 15

Side effects of antipsychotics?

Answer 15

Sedation
Difficulty initiating movement -PD
Extrapyramidal see effects - rhythmic movements
Tardative dyskinesia - lip smaking, tongue protrusion
Ataxia

Question 16

What is pressure of speech?

Answer 16

Fast speech making little sense with little sense of conecton

Question 17

What is Echolalia?

Answer 17

Reflection utterance of word said by others - schizophrenia

Question 18

What is Palilalia?

Answer 18

Involuntary repetition of words, words are from themselves - schizophrenia

Question 19

How is Mood different from Affect?

Answer 19

Mood is reported (subjective) by the patient. Affect expressed emotions by the patient.

Question 20

How are the thoughts sections of the MMSE sub divided?

Answer 20

Form - how thoughts are constructed

Content - what e.g: delusion

Question 21

What may be seen in thought form for a patient with schizophrenia?

Answer 21

Thought block
Derailment
Metonyms
Neologisms

Question 22

What are metonyms and who get them?

Answer 22

Word approximation - word holder for book

Dementia, schizophrenia, mania

Question 23

What may be seen in thought form for a patient with mania?

Answer 23

Flight of ideas - understand links
Word salad
Circumstantiality

Question 24

What is a perversion of thought form?

Answer 24

Repition of thoughts or phrase, commonly cannot move away from that line of thought.

Seen in OCD, psychosis, Frontal lobe dementias

Question 25

What is a delusion?

Answer 25

A fixed, false belief that lived outside of cultural, religious context

Question 26

What is an over valued idea?

Answer 26

A thought which takes precedence over other ideas, can be challenged (and therefore isn't fixed like a delusion)

Question 27

What is a nihilistic delusion?

Answer 27

I do not exist - typically in depression

Question 28

What is a Somatic delusion?

Answer 28

A delusion of symptoms - psychosis

Question 29

What is a referential delusion?

Answer 29

Thinking things are referencing you - TV, Radio Seen in schizophrenia

Question 30

Delusion of perception?

Answer 30

External stimuli is contested to a delusion - schizophrenia

Question 31

What is Othello delusion?

Answer 31

Partner is being unfaithful

Question 32

What is Capgras delusion?

Answer 32

Someone is replaced by a identical clone

Question 33

What is Couthards delusion?

Answer 33

Belief that they are dead, do not exist or do not have internal organs

Question 34

What is Ekboms delusion?

Answer 34

Belief of infection with insect or parasites

Question 35

What is Fregoli delusion?

Answer 35

Many people are infact the same person

Question 36

What does Passivity in respect to thought content?

Answer 36

Subtype of delusion - thoughts (insertion, control), feeling and actions (impulses and actions)

Question 37

What is a perception?

Answer 37

The process of turning an external stimuli into a meaningful psychological information

Question 38

What is an illusion?

Answer 38

Presence of a stimulus which leads to a misperception

Question 39

What might a fluctuation, polymorphic (in respect to modalities) indicate?

Answer 39

Delusion

Question 40

What Acronym can be used for insight?

Answer 40

RATE Rationalisation Attribute Treatment Engagement