Mental+Status

=Reading= Andreason, chapter =Goals=

7. Know the ways to asess the patients cognitive functions, such as orientation, concentration, attention, memoryuse of language, fund of knowledge, abdstraction, judgement, and insight
1) MSE normal mental status exam abnormal

background points: psych physical exam equivalent of a physiccal exam organised way describe looks, thinks, acts, behaves mostly observational meet a new person....size them up automatic teach terms in addition to lecture, small groups where meet patient 2-3 psych interview pt, then discussion, diagnosis dress nicely 1-3 handouts...3rd hour

parts of mental exam basic...how does look, what wearing, what is speech like, how behaving towards interviewer "laying in bed in hospital gown, eyes closed, responsive" First: appearance Second: How reacting to you, vs ignoring MD, or talking to self Psychomotor activity...nervous movement...abnormal on both sides agitated....really exaggerated, sped up speech--mechanical production of speech: loudness, clearness, stutter some also include thought process quantity of speech-how many words language abnormalities--use of symbols to communicate

Mood vs Affect: Mood: prevailing emotional state Affect: How mood is epxressed moment to moment appropriateness variability lability--rapid changes in emotional state blunted...not normal range flat...little or no emotion

Thought: Thoguht process vs thought form how ideas fit together usually our thoughts follow together with some logic significant thought disorders may be hard to follow also poverty of thought blocking....slow to answer ask...'what's going on? trouble coming up with answer? or too many thoughts?' flight of ideas loose associations--thoughts not connecting circumstantiality-get back to point tangentiality--never get back to question

Thought content: what is being thought only can ask pt Ideas of reference: belief that some unimportant event is important directly to patient delusions: false fixed beliefs--radio add just to them thought broadcasting, thought transferrance compulsions--meaningless task phobia-fear of specific thing

Perceptual disturbances--vs thought content illusions: MISINTERPRETATION OF REAL THINGS hallucination: perception in the absense of stimuli visual, auditory, oflactory, gustatory, tactile, haptic, hypnagoguic-as fall asleep

Dissociative status: depersonalization: not themselves Derealization: world around them is not real

Mental status exam level o0f consciousness: awake, alert orientation, who, where, when Mmory fund of knowledge use of lanugage abstractions insight--understanding self, medications, illness judgement--capable of making right decision

MMSE: formal test orientation memory Serial sevens-testing concentration or months backwards from october repeating: no if's, and's, or but's

< > schizopherneic they were infleicted on me at a tender age by a surgeon I guess at what age? the beiginning of life? bbirth? I was suffering from meningitis or something like that part of the treatment other thoughts about it birth itself was messy kidnapped after buirth surgeons cuts just added more fuel than fire out to do them in I strongly suspect that's true because, uh....*sigh* the dreams I've had lately would tend to prove it stereotypical smacking of lips dishevelled hair, checkered shirt no, not scarred, or other problems with heart just wish I was stronger...in the hands I feel generally weak flat affect talents or abilities? skill from electronic school...read circuit boards...anybody else would have the same famous in any way? No, don't think I'm famous or wealthy? Sometimes I think I have a high IQ...not especially high though more holy than most people

date: Today is uh...*sigh* May 13, 1994...no, it's the 18th What day of the week: Wednesday Do you know where we are: 1500 waters place what hospital: bronx state 6th floor

president of the united states...Mr. Clinton, Mr. Gore Governor: Cuomo, Mayor: Juliani Do you follow the news? To a certain extent I do...don't read the times, but I watch TV Place in Bosnia...some civil war there. Questions about similarities and differences: same between apple abnana, fruits table and chair? Uh...Wood products...Is there any other way they are the same? (sighs, scratches chin)

tardive diskinesia--mouth poor eye contact...shaven, decreased physical movement speech slow, normal clarity

affect, mood: flat hard to guess at mood believes more holy surgeon did something to him responses sometimes slow disjointed
 * formal thought disorder**--disorder of thought form

alert...fairly well oriented...no test of memory...fund of knowledge...difficulty in abstraction

emerald green is for cousin's earthly ship...she is professing to be..we know she is a witch doctor clip...bellevue Mrs. Abba, telling that have medical background neuropsychiatrist self-employed at laptop computer systems creator of laptop computer systems and most other computer systems how can we help you? how I can help you the accounting department.... 33yo white female with dishevelled hair agitated, movements with mouth glancing all over....affect slightly more labile that normal

behavior, dishevelled rapid movements, rapid thoughts loose associations mood? affect? Seemed pretty good Thought content: grandiose cognitive exam: awake, alert, attentive to examiner