Psychiatric History & Mental State Examination Flashcards
(31 cards)
components of an MSE?
"ASEPTIC" Appearance + behaviour Speech Emotion - mood and affect Perception - hallucinations and illusion Thought Insight + judgement Cognition
main mnemonic for psychiatric symptoms?
SOCRATES again (remove S+R)
what should be included in past psychiatric history?
previous diagnoses their timescale symptoms in previous episodes effect on function previous contacts admissions/detentions
how can you relate PMH to psych?
effect of their PMH on their functioning
relevance to mental health symptoms
how can you find out how severe a psychiatric illness is in the history?
any admissions?
ask about effect on function
what extra things are asked in a psychiatric social history?
chronological!!!
upbringing - family (divorce?), health
school - bullying? academics? behaviour?
work- jobs, performance, leave?
relationships- length, breakups, children?
current living situation- housing, finances?
how should you ask a forensic history?
any trouble with the police in the past?
what is the patient’s premorbid personality?
what they were like before their symptoms
what should you ask to find out the patient’s premorbid personality?
"what were you like before these problems started?" attitudes to self and others relationships interests temperament standards and values religion
what is affect?
your observation of how the patient is
what is mood?
a pervasive and SUSTAINED emotion
an MSE requires an explanation for each observation T or F
F, no explanation needed
what can be commented on in the appearance section of an MSE
age, gender, race, weight (begin with this)
self care - attire/grooming
posture
gait and movements
evidence of injuries eg self harm/injection sites
smell
components of the “behaviour” section of an MSE?
eye contact rapport open or guarded? agitated or slow to react? disinhibition or overfamiliarity?
how should you assess speech in MSE?
rate amount tone volume speech delay
increased speech is called ___ speech
pressure
decreased speech where the patient only answers yes/no is called ____ speech
monosyllabic
how could you work out mood for an MSE rather than for the history?
“how are you feeling TODAY?”
write down what they say
how do you note down affect in MSE?
write down the emotional tone the patient is expressing eg distressed AND if it varies
euthymic means…
normal
affect should be ____
reactive
what is a flattened affect?
not showing any positive affect and negative affect is raised
how will a blunted affect present?
very neutral, neither positive nor negative
a blunted affect is a common sign of what condition?
schizophrenia
