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11 Cards in this Set
- Front
- Back
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Mental State Exam |
A- Appearance and Behaviour S- Speech E- (Emotions) Mood and Affect P- Perceptions T- Thoughts I-Insight C-Cognition Risk Assessment |
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Appearance |
Observe the patients dress style Casual, formal, inappropriate, flamboyant Condition of hair, jewellery, tattoos, scars Level or cleanliness Are they well groomed and well presented or dishevelled General physical condition Abnormal involuntary movements Tics, grimaces, stereotypies, dyskinesia, tremor ìDo they have any body odour or smell of alcohol Do they appear to be unwell Responding to perceptual abnormalities |
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Behaviour |
Level of motor activity Overactive/Restless/Psychomotor retardation Level of alertness observed Subtleties of movement Posture or gestures Do they maintain eye contact Comment on body language & facial expressions Overfamiliar/Sexually inappropriate Appropriateness of behaviour |
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Behaviour and Attitude |
ìCooperativeìFriendlyìUncooperativeìHostileìAnxiousìTearful ìDistractibleìAggressiveìGuardedìSuspiciousìAppropriateìEstablishingrapport |
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Speech |
Rate Tone Volume Fluency& coherence Spontaneity Examples– Emotional, Hesitant, Loud, Monotonous Quality& Quantity Pressure Poverty Difficultiesspeaking Dysarthria Dysphasia Word-findingdifficulty Accent Neologisms |
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Mood and Affect |
Moodis a sustained feeling state Howthe patient reports their emotions as being Subjective& Objective assessment Moodcongruence – between mood & affect Affect isthe moment to moment expression of feelings Howdoes the mood appear to you Reactive,Irritable, Anxious Affect may not reflect mood andcan change during the interview ìEuthymicìDepressedìDysphoricìAnxiousìElatedìEuphoricìIrritable |
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Risk Assessment |
Passive death wish (PDW) Life not worth living (LNWL) Hopelessness/Helplessness Thoughts of self harm (TSH) Thoughts of harm to others (TOHO) Thoughts of suicide (SI) Plan Intent |
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Thoughts |
Abnormality of thoughts Stream,Form & Content Stream Pressureof thought Povertyof thought Blockingof thought Form – The formation of thought (FTD– Formal Thought Disorder) Looseningof associations - Tangential Illogical - Circumstantial Derailment - Flight of ideas Incoherent - Poverty of content Perseveration Content(nature) Obsessions– obsessive thoughts/ideas/impulses Phobias Overvaluedideas Preoccupations Delusions Whatis on the patients mind during the interview and most of the time Enquireabout any preoccupations, worries, phobias or recurrent thoughts |
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Perception |
Atruehallucination will be perceived as being inexternal space, distinct from imagined images, outside conscious control and aspossessing relative permanence Apseudo-hallucinationwilllack one or all of these characteristics and be subjectively experienced asinternal or ‘in my head’ 1.Auditory hallucinations1.Hearinga voice speak one’s thoughts aloud (thought echo)2.Hearinga voice narrating one’s actions (running commentary)3.Hearing2 or more voices arguing 2.Visual hallucinations1.Organic disorder until proven otherwise2.Drug/Alcoholintoxication or withdrawal3.Lilliputianhallucinations (DTs) 3.Olfactory 4.Tactile 5.Gustatory Dissociation: Depersonalisation –a change of self awareness such that a person feels unreal & detached fromhis own experience Derealisation –objects or the environment feel unreal Bothexperiences are unpleasant |
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Cognition |
Cognitivestate of many patients can be reduced Dementia Delirium Secondaryto other psychiatric disorders MMSE Orientation– Time/Place/Person Attention Concentration Memory |
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Insight |
Doesthe patient acknowledge that they are unwell? Dothey recognisetheir symptomsas abnormal? Dothey believe that they have a psychiatric disorder? Dothey feel that they need treatment? |
