Mental State

Question 1

what are the areas of mental state exam

Answer 1

appearance, speech, thought form, mood and affect, disorders of thought content, perception, cognition, insight

Question 2

what are you looking for in appearance

Answer 2

general health, posture, tattoos, piercings, injection sites, well kempt?, mannerisms, eye contact, rapport, abnormal movements- result of antipsychotics or tics, stereotypy, mannerisms, motor activity

Question 3

what are you looking at in speech

Answer 3

tone, rate, volume

Question 4

what is normal speech

Answer 4

spontaneous, relevant, logical, coherent

Question 5

what is circumstantial speech

Answer 5

takes a long time to get to the point

Question 6

what is perseveration (speech)

Answer 6

repeating of words or topics suggests frontal lobe dysfunction, schizophrenia, OCD

Question 7

what is neologisms (speech)

Answer 7

made up words- can occur in schizophrenia

Question 8

what are some abnormal forms of thought

Answer 8

flight of ideas (abnormal connection), loosening of associations (no discernible link, Knights move), thought block (subjective experience of thought is abnormal)

Question 9

what happens in pressured speech (can occur in mania)

Answer 9

incr rate and volume

Question 10

what happens to speech in depression

Answer 10

poverty of speech and thought block- decr tone, rate, vol

Question 11

what is mood

Answer 11

patients underlying emotion report subjective mood and objective- euthymic, dysthymic, hyperthymic

Question 12

what is affect

Answer 12

observed external manifestation of emotion. blunted (schizophrenia), labile, irritable, suspicious

Question 13

what is labile

Answer 13

excessively changeable

Question 14

what is incongruous (affect)

Answer 14

grossly out of tune with subjects being discussed eg laughing about bereavement

Question 15

what is the affect described as if it is normal and no abnormality

Answer 15

reactive

Question 16

what are some disorders of thought content

Answer 16

negative, ruminations, beliefs, delusions, phobias, obsessions, depersonalisation, derealisation, ideas of reference

Question 17

what are ruminations

Answer 17

persistent, disabling preoccupations

Question 18

what is depersonalisation

Answer 18

feeling detached, unreal

Question 19

what is derealisation

Answer 19

feel like the world and people are lifeless

Question 20

what are delusions

Answer 20

disorders of thought content. fixed, false beliefs out of keeping with culture

Question 21

examples of delusions

Answer 21

grandiose, persecutory, of reference, thought insertion/withdrawal/broadcast, passivity

Question 22

what are grandiose delusions

Answer 22

being famous, having supernatural powers, enormous wealth

Question 23

what are persecutory delusions

Answer 23

someone interfering in a malicious way

Question 24

what are delusions of reference

Answer 24

other people, media etc talking about you or communicating to you

Question 25

thought withdrawal/insertion/broadcast

Answer 25

external someone controlling thoughts

Question 26

passivity

Answer 26

actions, feelings being controlled by external

Question 27

what can be abnormal perceptions

Answer 27

illusions, hallucinations, psuedohallucinations

Question 28

what is an illusion

Answer 28

misintepretation of normal perception can occur in healthy people

Question 29

what is a hallucination

Answer 29

perception in the absence of external stimulus

Question 30

what is a pseudohallucination

Answer 30

internal perception with preserved insight

Question 31

what are you testing in cognition

Answer 31

conciousness, memory, orientation, concentration, attention

Question 32

what test can you do for cognition

Answer 32

Mini mental state examination (MMSE)

Question 33

insight

Answer 33

understanding of condition, cause and willingness to accept treatment

Question 34

what is echolalia

Answer 34

repeating another persons words

Question 35

what is cotard delusion

Answer 35

believe dead already or dying, losing blood, organs etc

Question 36

what is capgras delusion

Answer 36

delusion that friend, spouse etc have been replaced by identical looking imposter

Question 37

what is couvade delusion

Answer 37

sympathetic pregnancy- husband gets symptoms of mothers pregnancy

Question 38

what is Fregoli delusion

Answer 38

belief that friend, spouse is replaced by a twin imposter

Question 39

what is Ekbom delusion

Answer 39

delusional parasitosis- psychosis

Question 40

difference between primary and secondary delusion

Answer 40

primary- not understandable, fixed- capgras, cotard, etc etc. secondary can be understandable in mood context- persecution, grandiose etc

Question 41

what is echo de la pensee

Answer 41

thought echo-voices heard within mind

Question 42

in auditory hallucinations what should you differentiate

Answer 42

if it is a second person or a 2nd person talking to 3rd person