Psychiatric Interview Flashcards
1
Q
Sxs relating to mood:
- Angry
- Happy
- Sad
A
Psychological Sxs
2
Q
Somatic Sxs relating to body sensation:
- Pain
- Fatigue
- Palpitations
A
Physical sxs
3
Q
Do most patients present with psychological complaints, or physical complaints?
A
- 2/3 pts w/ depression present w/ physical complaints (fatigue/back pain)
- 1/3 pts w/ depression complain of multiple unexplained somatic sxs
4
Q
- What is the frequency of “difficult patient encounters?”
- Explain this encounter
A
- 15 - 20% (3 to 4 visits / day)
- Patients w/ unexplained/somatic sxs
5
Q
Unexplained sxs lasting how long should raise concern for underlying depression, anxiety, or both?
A
Over 6 weeks
6
Q
Little interest or pleasure in doing things
A
Anhedonia
7
Q
Most screening questions for depression and anxiety ask if pt have been having sxs over the past 2 weeks. Which question is asked for 4 weeks?
A
Have you had an anxiety attack (suddenly feeling fear or panic)?
8
Q
What is the mnemonic for depression?
A
SIGECAPS
9
Q
S
I
G
E
C
A
P
S
A
- S- sleep disturbance
- I - interests decreased
- G - Guilt (worthless, poor self esteem)
- E - energy decreased
- C - concentration decreased
- A - appetite disturbance
- P - psychomotor changes
- S - suicidal thoughts
10
Q
What is the anxiety mnemonic?
A
WATCHERS
11
Q
W
A
T
C
H
E
R
S
A
- W - Worry
- A - Anxiety
- T - Tension in muscles
- C - Concentration difficulty
- H - Hyper arousal/irritability
- E - Energy loss
- R - Restlessness
- S - Sleep disturbance
12
Q
A patient is considered “seriously ill” if they exhibit which sxs?
A
Losing interest in sex, hobbies, reading, or TV
13
Q
Substance abuse mnemonic for ETOH?
A
- C - have you eve felt you should CUT back?
- A - ANGRY or ANNOYED at others comments about your use?
- G - GUILTY about your use?
- E - EYE opener to get you going in morning?
14
Q
Substance abuse mnemonic for prescription med abuse?
A
- W - Work, school, or home role obligation failures
- I - Interpersonal or social consequences
- L - Legal problems
- D - Dangerous use
15
Q
What is the psychological equivalent of a physical exam?
A
Mental Status Exam (MSE)
16
Q
- Describes mental state & behaviors
- Incudes objective observations of clinician
- Includes subjective descriptions given by pt
- Utilized to establish dx, develop tx, & monitor progress
- “snap shot in time”
A
MSE (mental status exam)
17
Q
What 3 PE components should you also always include in a PE of a psychiatric interview along w/ MSE?
A
- Cardiac
- Pulmonary
- Vitals
18
Q
- Situation where feelings, desires, and expectations of one person are unconsciously redirected and applied to another.
- Give example
A
- Transference
- (maternal transference)
19
Q
- Provider unconsciously projects his/her feelings towards a pt
(provider develops attachment to pt)
- What should you avoid??
A
- Counter-transference
- Avoid entanglement
20
Q
Many psychiatric disorders are “familial.”
What else is familial?
A
The patient’s response to tx
21
Q
What are the 6 major components of an MSE?
A
- Appearance/Behavior
- Speech/Language
- Mood/Affect
- Thoughts/Perceptions
- Insight/Judgement
- Cognition
(SAMTIC)
22
Q
- The ability to focus/concentrate over time on particular stimulus or activity.
- An inattentive person is easily distractible and may have difficulty giving a hx or responding to questions
- Give an example
A
- Attention
- Ex: pt on cell phone
23
Q
- The process of registering or recording info, tested by asking for immediate repetition of material, followed by storage or retention of info.
A
Memory
24
Q
Cover minutes, hours, or days
A
Recent / Short term memory
25
Refers to intervals of years
Remote / Long term memory
26
* Awareness of personal **identity**, **place**, and **time**
* Requires both **memory** and **attention**
Orientation
27
* Sensory awareness of objects in environment & their interrelationships (external stimuli)
* Refers to internal stimuli such as dreams or hallucinations
Perceptions
28
* The logic, coherence, and relevance of the patient's thought as it leads to selected goals
* "How people think"
Thought processes
29
* What the patient thinks about (level of insight & judgement)
Thought content
30
* Awareness that sxs or disturbed behaviors are normal or abnormal
* Ex: distinguishing between daydreams and hallucinations that seem real
Insight
31
* Process of comparing & evaluating alternatives when deciding on course of action
* Reflects values that may/may not be based on reality & social conventions of norms
Judgement
32
* A fluctuating pattern of observable behaviors that express subjective feelings or emotions through tone of voice, facial expression, & demeanor
* Give 4 examples
* "visualized by provider"
* Affect
* Flat, blunted, labile, inappropriate
33
* A more pervasive and sustained emotion that colors the person's perception of the world
* May be: _euthymic_ (normal range), _elevated_, _dysphoric_ (unpleasant = sad/anxious/irritable)
* "Patient describes this"
Mood
34
* A complex symbolic system for expressing, receiving, & comprehending words
* As with consciousness, attention, and memory, what is essential for assessing other mental functions?
Language
35
* Assessed by _vocabulary,_ _fund of info_, _abstract thinking_, _calculations_, _construction of objects_ that have 2 or 3 dimensions
Higher cognitive functions (mini mental status exam)
36
Level of consciousness which can be _associated w/ substance abuse_
Hyper-alert
37
Opens eyes, looks at you and _responds appropriately to stimuli_
Alert
38
"_drowsy_" - opens eyes, looks at you, _responds to questions, then falls asleep_
Lethargic
39
Opens eyes, looks at you, _responds slowly and somewhat confused_
Obtunded
40
Arouses w/ painful stimuli, slow or absent verbal responses, _lapses into unresponsive state when stimuli cease_
Stupor
41
Unarousable w/ eyes closed
Coma
42
* Comprehension intact
* Unable to speak to varying degrees
* (Pt can point to nose when prompted to do so)
* (Pt can write words)
Expressive aphasia (Broca's)
43
* Comprehension not intact
* Fluent, but nonsensical speech
Receptive aphasia (Wernicke's)
44
Combination of receptive & expressive aphasia
Global aphasia
45
Aphasias are common with which 3 things?
* Strokes (MCA - medial cerebral artery)
* Trauma
* Mass lesions
46
Impairment of language ability
Aphasia
47
* Prevalent emotional states the pt communicated to you
* Often placed in "quotes"
* duration
* Appropriate given the situation
Mood
48
Themes tht occupy the patients thoughts and perceptual disturbances
Thought content
49
