Mental Status Exam

Question 1

Fundamental components of the mental status exam

Answer 1

• Information processing / cognition
• Individualized framework for information
• Neurochemical state

Question 2

ABSEPTIC

Answer 2

Mental status exam mnemonic

Appearance, Behavior, Speech (motor aspect of language), Emotion (mood/affect), Perceptions, Thought (process, content), Insight (and judgement), Cognition

Question 3

When assessing for SI, it is important to dinstinguish between __ and __

Answer 3

When assessing for SI, it is important to dinstinguish between passive SI and active SI

Passive SI is common in patients with chronic pain or chronic discomfort. “I just wish I would have a heart attack and not wake up.” This patient does not need psychiatric care, they need better pain control.

This is not the way that patients with active suicidal ideation and intent think.

Question 4

Many times when an individual overdoses or injurs themself in a severe, life-threatening way, it is . . .

Answer 4

. . . an impulsive, in-the-moment phenomenon that does NOT indicate suicidal ideation

Question 5

Diagnostic criteria for GAD

Answer 5

* Persistent, excessive, uncontrollable anxiety/worry \> 6 months
* Person struggles to control the worry
* At least three of these symptoms:
* Disrupted sleep
* Fatigue
* Impaired concentration
* Irritability
* Muscle tension
* Restlessness

Question 6

Treatment of GAD

Answer 6

Most effective approach utilizes pharmacotherapy and psychotherapy​

**CBT** is most effective for psychotherapy

.​**SSRIs** are the first-line pharmacotherapy.

If these fail, **SNRIs** or **TCAs** may be tried.

Other possibilities for augmentation include **benzodiazepines, hydroxyzine, buspirone, mirtazapine.**​

Benzodiazepines may be utilized as a **bridging therapy** until the SSRI or other medication becomes therapeutic.​Treatment plan should also consider comorbid disorders.