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Personality disorders, mental retardation |
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General medical conditions |
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Psychosocial and environmental problems |
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Global assessment of functioning |
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Schizophrenia Bipolar disorder Panic disorder (are all considered an illness not a maladaptive behavior) |
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Comprises personality disorders and mental retardation Maladaptive personality traits and behavior problems |
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Primarily records medical problems relevant to the ongoing treatment of a patient |
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Examples: Glaucoma requiring antidepressants Asthma in patients with anxiety requiring anti-anxiety medications AIDS in a patient with new-onset psychosis (brain lesions) Cirrhosis of the liver in a patient with alcohol dependence |
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Records psychosocial stressors encountered by the patient within the previous 12 months contributing to: Development of a new mental disorder Recurrence of a previous mental disorder Exacerbation of an ongoing mental disorder |
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Records the patient’s global level of functioning: Both at the time of evaluation and during the past year Clinician consults the Global Assessment of Functioning (GAF) scale to determine the level of functioning GAF is based on 0-100 scale |
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Uses psychological, social, and occupational component to determine assessment of function |
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Global Assessment of Functioning (GAF) |
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Global Assessment of Functioning (GAF)scale based off the |
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Doctors opinion The higher the score the better |
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Mental illness is not classed in the same method as physical illness because: |
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Hard measures are much more difficult Definitive diagnosis become elusive |
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The DSM Can be viewed as: |
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Close-minded Reductionistic Fixed |
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Mental status is the total expression of a person’s |
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Emotional response Mood Cognitive function Personality |
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Menatal status is closely linked to the individual’s executive functioning such as |
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Motivation, initiative, goal formation, planning and performing, self-monitoring, and integration feedback |
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Frontal lobe functions in |
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Speech formation (broca area) Emotions Affect (emotional tone, dull, flat) Drive Awareness of self Short-term memory Goal-oriented behavior |
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Parietal Lobe functions in |
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Temporal Lobe functions in |
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Perception and interpretation of sounds (and determination of the source) Wernicke speech area (comprehension of written and spoken language) Integration of behavior, emotion, and personality Long-term memory |
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Survival behaviors – mating, aggression, fear, affection Reactions to emotions, and expression of affect is mediated by connections of the limbic system and the frontal lobe |
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Dementia is a clinical syndrome, characterized by |
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deteriorating cognition, behavior, and functional independence |
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nutritional and nervous system |
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Delirium is different than dementia in that it is |
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an acute confusional state accompanied by a disorder of perception |
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Symptoms for delirium include: |
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Alterations in mental status Attention span Sleep patterns affect |
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Major Components of the MSE |
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Appearance Motor Speech Affect Thought Content Thought Process Perception Intellect Insight |
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Age Gender Race Body build Posture Eye contact all fall under this cat. of MSE |
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Hesitancy Agitation Abnormal movements Gait Catatonia (not moving, speaking, or talking all fall under this cat. of MSE |
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Rate Rhythm Volume Amount Articulation Spontaneity all fall under this cat. of MSE |
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Stability Range Appropriateness Intensity Affect Mood all fall under this cat. of MSE |
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Suicidal ideation Death wishes Homicidal ideation Depressive cognition Obsessions Phobias Paranoid ideation Ruminations pondering (thoughts that can’t be let go) Magical ideation (bizarre linking of outcomes) Delusions Overvalued ideas all fall under this cat. of MSE |
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Associations (can’t stay on tract) Coherence Logic Stream (are they able to logically put together a process of thoughts, or do they tell you everything they are thinking) Clang associations i.e. frog/dog Perservation Uncontrollable repetition of a response, word, phrase, gesture Neologism Invention of new words Blocking (find their own thoughts disturbing) Attention all fall under this cat. of MSE |
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Thought Process (how they think of these thoughts) |
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Hallucinations Illusions (self referancing things in your environment) Depersonalization (talk about self in 3rd person) Derealization Déjà vu Jamais vu – it’s new every time all fall under |
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Global impression Average Above average Below average describes |
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Awareness of illness describes their |
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Orientation Immediate and short term memory Concentration Arithmetic ability Language Praxis (learning) |
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Inability to recognize and identify familiar objects or persons Difficulty recognizing geometric features |
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Defect or loss of expressive ability Speech Writing Signs
Inability to comprehend spoken or written language |
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Inability to make learned coordinated movements, example folding a piece of paper in half |
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Include the MMSE in the ________ section of your narrative history |
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Usefulness of the MSE & MMSE limited by |
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Age over 60 Education less than 9th grade Cultural experiences Low socioeconomic status |
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Traditional threshold for the MMSE: |
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Post-traumatic stress disorder Alcohol abuse are found in |
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imaging provides a measure of regional blood flow (like a more specific bone scan) utilized to assess brain FUNCTION |
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Single emission computed tomography (SPECT) |
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imaging provides a measure of metabolic activity by marking glucose utilization utilized to assess brain FUNCTION |
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positron emission tomography (PET) |
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Most commonly utilized advanced imaging procedures in the mental health field (an in neurology): Can assess brain STRUCTURE |
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Computed tomography (CT) Magnetic resonance imaging (MRI) |
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provides an instantaneous, localized measure of electrophysiological activity of the brain |
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Electroencephalography (EEG) |
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Dementia structural assessment of atrophy |
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Dementia blood flow patterns may identify Alzheimer's disease |
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Dementia characteristic increase in slow wave activity in dementia |
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Tumor useful to assess tumor vascularization |
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Tumor may reveal focal slowing |
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Parkinson’s disease useful after infraction |
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Parkinson’s disease may identify early ischemic changes before CT and MRI |
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Parkinson’s disease identified characteristic defects in neuroanatomy |
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Parkinson’s disease identifies decreased uptake of F-DOPA |
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