MSE

Card Set Information

Author:
trincam2008
ID:
275015
Filename:
MSE
Updated:
2014-05-21 19:11:38
Tags:
psy historytaking
Folders:
Psychiatry
Description:
Mental State Examination - AS(t)EPTIC
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  1. A & B
    Appearances
    • - Level of consciousness
    • - General impression: 
    •    (body built, of physical illness, posture, cleanliness, w loss, self harm)
    • - Face: facial expression
    •    (eye contact, expression, blank & expressionless)
    • - Dress
    •    (bizarre, dirty, revealing, inapp. for weather, extra layers, cover up)
  2. A & B (2)
    Behaviours
    • - Motor:
    •    (speed, repetitive or rhythmic writhing (choreoatheosis), chewing of mouth/trembling lips in tar dive dyskinesia), abnormal movements, rituals
    • - Attitude to interview   
    •   (friendly, hostile, suspicious)
  3. S
    Speech
    • 1. Speech form
    • - Spontaneity
    • - Speed
    • - Volume
    • - Quantity
    • - Quality

    • 2. Speech content
    • - Neologism
    • - Punning & clang associations
    • - Expressive dysphasia (Broca's or non-fluent dysphasia)

    • - Obscene words
    • - Poor fluency
    •   + poor education
    •   + thought disorder/circumstantiality
    •   + receptive dysphasia (Wernicke's or fluent dysphasia)
    •   + echolalalia
    •   + perseveration
  4. Thought form
    • 1. Fluency
    • - Circumstantiality
    • - Loosening of associations
    • (extreme word salad)
    • 2. Flow
    • - Changes: in speed, V
    • - Interruptions:
    •    + Thought block
    •    + Perseveration
    • - Deviations:
    •   + Derailment
    •   + Tangentiality
    •   + Flight of ideas
    • - Funny words
  5. Emotions
    Affects (objectively) and Mood (subjectively)
    • 1. Affects
    • - Euthymic?
    • - Types: adj: happy, sad, angry, detached, appropriate, congruous
    • - Intensity
    • - Stability:
    •   + in degree of intensity
    •   + variability of type: blunted or labile
    • - Appropriateness
    • - Congruity

    • 2. Mood
    • - Types
    •   + Depression
    •   + Hypomania
    •   + Anxiety
    •   + Irritability
    • - Intensity
    • - Chronicity
    • - Stability ( delusional mood)
  6. Perceptions
    • 1. Hallucinations
    • - Modalities: VAKOG
    •   + A: crude / complex
    •          second person voices, 3rd person voices, thought echo, commentary
    • - Complexity:
    •    (crude, complex)
    • - Trigger factors:
    •    (funtional hal, reflex, hypnogogic or hypnapompic hal)
    • - Other perceptual abnormalities
    •    (illusions, pseudo-hal, depersonalisation and derealisation, Capgras syndrome, Deja vu or jamais vu)
  7. Thought content
    • I. Types
    • - Primary delusions
    • - Secondary ''
    • - Systematised "
    • - Mood-congruent "
    • - Folie à deux

    • II. Themes
    • 1. Delusional content
    • - Persecutory
    • - Reference
    • - Control/passitivity

    • - Jealousy
    • - Amorous

    • - Grandiose
    • - Guilt
    • - Worthlessness

    • - Infestation - Ekbom
    • - Nihilistic
    • - Capgras - misidentification
    • - Hypochondriacal


    • 2. Non-delusional content
    • - Overvalued ideas
    • - Phobias
    • - Obsessional symptoms
    • (ruminations, ideas, memories, imagery)
    • - Suicidal ideation
    • - Hyponchondriasis
    • - Dysmorphophobia
    • - Eating disorders
  8. Cognition
    • * Domains x4
    • - Level of consciousness
    • - Orientation ( time -> date -> place -> person)
    • - Attention and concentration
    • - Memory: short- & long-term

    • * How
    • 1. informal: orientation to time, space and person
    • 2. formal testing: 
    • - Screening
    •    + AMTS
    •    + MMSE
    • - More detailed
    •    + ACE - Addenbrookes
    • - Pyschometric testing
  9. Insights
    • - is the pt aware that something is wrong?
    • - is the problem internal or external?
    • - does the pt think it is the result of an illness?
    • - is the problem physical or psychological?
    • - if psy, can it be helped?
    • - is the pt willing to accept help?

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