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-psychiatric equivalent of a physical exam -confirms/clarifies the pathology presented int he evaluation interview -describes and quantifies specific pathology -employs specific items and terminology |
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administration techniques of the MSE |
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-requires PASSIVE and ACTIVE data gathering -observation during the initial interview -specific questions regarding suspected pathology -standardized tests of specific functions |
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-appearance & behavior -psychomotor behavior -speech -mood -affect -thought -sensorium & intellectual functions -insight -judgement |
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-dress, grooming, hygiene -eye contact (and relatedness to examiner) -cooperation with exam -how the patient makes you feel |
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-how much the patient is using their body/motor activity to communicate who they are -posture and gait -frequency and normality of gestures -motor activity -other mannerisms or behavior |
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-mechanic of speech (+/- language, account for lang either here or in cognitive section) -rate -quantity -volume -fluency -clarity/articulation (mumbling, accent, impediment) |
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-pervasive and sustained emotional state -patient's subjective experience (may be given in the pt's own words) -part of a patient's emotion -3 major components: 1)degree of happiness/sadness; 2) degree of anger; 3) degree of anxiety -"euthymic" = "normal" or balanced |
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-outward manifestation of mood -how the patient shows feelings -manifested through facial expression, tone of voice, posture, gestures, etc -part of a pt's emotional state -2 components: 1) range; 2) content |
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-intensity and variability/reactivity -how the patient expresses their emotional state moment to moment -REACTIVE -LABILE -BLUNTED -FLAT -CONSTRICTED |
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normal responsiveness and range of emotions |
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highly variable range of affect |
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-predominant and secondary -appropriateness |
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1. process or form: how thoughts are formed, fit togeher and flow 2. content: what is being thought 3. perceptions |
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-associations -poverty of thought -blocking -racing thoughts -loose associations -circumstantiality -tangentiality |
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-thought process or form -associations: how things fit together, including rate and flow |
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-thought process or form -poverty of thought: few thoughts |
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-thought process or form -blocking: inability to form thoughts or losing track of thoughts |
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-thought process or form -racing thoughts, flight of ideas: rapid thoughts |
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-thought process or form -loose associations: disconnected thoughts |
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-thought process or form -circumstantiality: lots of extra details but eventually gets to the point |
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-thought process or form -tangentiality: connections between thoughts are apparent, but they drift away from the topic at hand |
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-what is being thought delusions, ideas of reference, insertion/withdrawal, reading or broadcasting, obsessions, compulsions, phobias, suicidal or homicidal ideation |
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-thought content: what is being thought -delusions = fixed, false beliefs |
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ideas (or delusions) of reference |
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-thought content: what is being thought -ideas of reference = belief that some often unimportant event is related specifically to the patient |
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thought insertion or withdrawal |
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-thought content: what is being thought -insertion/withdrawal = belief that thoughts are being taken out of or put into head |
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thought reading or broadcasting |
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-thought content: what is being thought -reading/broadcasting = belief that others are hearing or sending thoughts |
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-thought content: what is being thought -obsessions = distracting, persistent thoughts |
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-thought content: what is being thought -compulsions = irresistible urges to perform meaningless tasks |
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-thought content: what is being thought -phobias = irrational fears of specific things |
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suicidal or homicidal ideation |
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-thought content: what is being thought -suicidal or homicidal ideation = want to hurt oneself or others |
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-illusions -hallucinations -dissociative states |
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misinterpreted sensory inputs |
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perceiving input in absence of external stimulation |
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-visual -auditory -olfactory -gustatory (taste) -tactile (haptic) -hypnagogic/hypnapompic: hallucinations while falling asleep or waking |
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-depersonalization -derealization |
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dissociate state of feeling that one is not oneself |
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dissociative state of feeling that the world, people, and things around are not real or don't make sense |
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sensorium and intellectual (cognitive) functions |
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-level of consciousness -orientation -concentration/attention -memory -use of language -fund of knowledge -abtraction |
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-sensorium -is the patient awake and alert? |
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orientation to person, time, and place |
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can the patient pay attention to your questions and answer them |
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-immediate, new learning - remembering 3 things and recalling in 5 minutes -recent -remote, asking is they remember their own story/history |
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(tested here in cognition section or earlier during assessment of speech) -comprehension, follow 2-step directions -repetition -naming -reading -writing |
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-general intellectual level -ex: identifying past presidents, current events |
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-proverb interpretation -similarities (what do apple and orange have in common) |
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does the patient understand what they are in treatment |
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ex: what would you do if you found a stamped addressed envelope on the ground |
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