Mental State Examination Flashcards
(25 cards)
Anxiety types
Panic disorder Agoraphobia Specific phobia GAD OCD
Autonomic symptoms of panic disorder
Palpitations, tremor, sweating, chest pain, nausea
Palpitations
Psychological symptoms of panic disorder
Derealization/depersonalization, fear of losing control, dying
Prevalence of anxiety
1.5-3.7% prevalence
Specific phobia prevalence and symptoms
12.5% prevalence
Recrrent/excessive, unreasonable symptoms of anxiety- unproportionable level of fear
GAD prevalence and symptoms
2.4-6.4%
Excessive worry
Apprehension about everyday events
OCD prevalence and
0.5-3% symptoms
Ideal image or impulse
Recognized as own
Repetitive, intrusive, distressing
Compulsion symptoms
Unnecessary, purposeless action
Avoids occurrence or adverse event- gets in the way of normal life
Relieves anxiety
Mood disorders tyes
Depressive episode
Manic/hypomanic episode
Bipolar 1/2
Depressive episode prevalence and symptoms
10-20% prevalence
Core symptoms: depressed mood, anergia- loss of energy, anhedonia- a loos of pleasure
Biological symptoms: reduced self- esteem, self-confidence, ideas of guilt unworthiness, ideas/ acts of self-harm/suicide
ICD- 10 classification of depressive episode
ICD- 10
Mild: two core plus two others- not intense
Moderate: two cores plus 3/4 others, marked intensity- more severe than mild
Severe: three core plue four others, severe intensity> 2weeks. (+/- psychosis)
Manic episode traits
- Abnormally, persistent elevated, expansive/ irritable mood with 3 positive symptoms- 1week
- Increased energy, overactivity, reduced sleeep
- FTD- frontotemporal demential
- Increased self esteem reduced attention
- Psychotic symptoms
Hypomanic episode traits
Three of more symptoms over at least 4 days
Not severe enough to interfere with social/ occupational functioning
Require admission to hospital
Include psychotic feautures
Bipolar affective disorders
2+ episodes, one of which must be manic/hypomanic or mixed
Prevalence 0.3-1.5%
BPAD 1: mania- depressive and manic episodes
BPAD II: hypomania- depressive episodes and hypomanic episodes- depressive episodes MUCH more severe and longer lasting
Schizophrenia features
at least one of
At least one of
• Thought echo/ insertion/ withdrawal/ broadcast
• Delusions of control/passivity and delusional perception- other people are in control of your body / thoughts
• Audition hallucinations (3rd person, running commentary)
• Implausible delusions
Schizophrenia features at least two of
- Persistent hallucinations with non-affective delusions
- Breaks in train of thought
- Catatonic behavior- very agitated or very excited
- Apathy/blunting- not caring or not reacting very much to things
- Loss of interest/ social withdrawal
FOR AT LEAST ONE MONTH
Difference between positive and negative symptoms in Schizophrenia
- Positive- added symptoms- added hallucinations
* Negative-things taken away
MSE - appearance and behaviour
- Level of consciousness
- Appearance
- Race
- Grooming/hygiene
- Dress
- Build, posture, physical, condition, stigmata- harm themselves
- Attitude to examiner
- Facial expression, eye contact, rapport, engagement
Abnormalities of movement
- Amount- agitation, retardation, stupor
- Goal-directed: mannerisms vs stereotype
- Tics- motor vs vocal
Dystonia- side effects of anti-psychotics
Akathisia- inability to stay still
Myoclonus- muscle jerk- hiccups
Chorea- jerky involuntary movements- hips and face
Also induced movements (automatic, obedience, ambitendence, mitmachen- move people’s limbs to certain position, mitgehen, posturing- odd postures for hours on end , catalepsy, rigidity, negativism etc)
MSE- Speech features
Form vs content Amount: logorrhoea vs poverty Rate: pressure, retardation, mutism Volume Tone Neologism, clang/pun
MSE- Mood features
Pervasive, sustained emotional state Euthymic, anxious, irritable, depressed, euphoric, apathy Blunted flat Emotional incontinence Incongruous
MSE- Thought features
Stream, pressure, poverty, thought block
Dorm
Flight of ideas, move quickly, loosely associated
Loosening of associations: move quickly unconnected
Over-inclusive can’t preserve conceptual boundaries
Circumstantiality vs tangentiality
Derailment/ knight’s move
Thoughts
Delusions
A fixed belief held in the face of evidence to the contrary which cannot be explained by culture or religions
Primary: fully formed, irreducible/ un-understandable, autochthonous delusion perception, delusional memory, delusional mood
Secondary: arises from previous ideas/events (delusional elaboration)
Systematized: common theme, multiple elaboration
Persecution
Control: passivity of affect/impulse/volition/somatic passitivity
Misidentification : Capgras- people you know have been replaces vs Fregoli- people you see but don’t know are people you know wearing a disguise
Grandeur
Religious
Guilt
Nihilism- got no money/ house. Possessions/ part of your body
Jealousy/Love: organic/alcoholic: Othello- pathological jealousy- mainly in men who think their spouse is having an affair, de Clearbault syndrome- women when they believe that a perception is in love with them
Somatic: physical defect/medical problem
Thought insertion/withdrawal broadcast
Thoughts of self harm
Thoughts of harm to others
MSE- Perceptions features
Sensory distortion
Depersonalisation/derealization
Illusion: misinterpretation of a stimulus
Hallucination: occurs in the absence of a stimulus, arising from external space, share the quality of a real perception
Sensory modality, content, mood congruence
Auditory 2nd/3rd person, thought echo
Olfactory, gustatory, tactile
MSE- cognition features
Orientation: time, place, person
Memory: immediate/delayed recall, working memory
Formal cognitive assessment
