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Class 2

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Class 2

  1. 1. MENTAL STATUS EXAMINATION 1
  2. 2. Mental status examination• Consciousness• Rapport• General appearance and motor behavior• Attention and concentration• Language functions• Orientation• Memory• Abstract ability• Judgment• General information• Calculation• Intelligence 2
  3. 3. Mental status examination• Thought o Stream o Form o Possession o Content• Mood and Affect• Perception• Other psychotic phenomena• Insight 3
  4. 4. Thought Stream- (Progress) o Spontaneity o Volume o Tonal fluctuations o Retardation o Pressured speech 4
  5. 5. • Poverty of speech: Restriction in amount, brief, concrete, unelaborate• Poverty of content: Long reply, adequate speech, less content 5
  6. 6. • Flight of Ideas:• Thoughts follow each other rapidly• No general direction of thinking• Connections between successive thoughts appear to be due to chance and can usually be understood (alliteration, clang)• E.g.: I live in Birmingham, Kingstanding, see the king, sing sing, bird on the wing…. 6
  7. 7. • Prolixity: Ordered flight of ideas• Speed not as fast• Despite irrelevances, able to return to the task• Circumstantiality:• Unnecessary and trivial details, but finally the point is reached• Goal is never completely lost 7
  8. 8. • Inhibition or retardation:• Train of thought is slowed down• Number of ideas, images decrease• Usually experienced as difficulty in making decisions, lack of concentration or loss of clarity of thinking• Depression 8
  9. 9. Mood and affect• Mood- Prolonged subjective prevailing state or disposition;• Sad, happy, worried, angry, fearful;• Depth; predominant mood over the last 1 week• Affect- Objective state; range, reactivity, mobility and communicability;• Depressed, elated, euphoric, anxious, perplexed, blu nted 9
  10. 10. Other psychotic phenomena• Somatic passivity- bodily sensations especially sensory symptoms experienced as imposed by external force• Made action, affect and impulse• Negative symptoms• Depersonalization and derealization 10
  11. 11. Insight• Awareness,• Attribution and• Acceptance of intervention 11
  12. 12. 6 grades o Grade 1: Denial o Grade 2: Slight awareness but denying it at the same time o Grade 3: Awareness present but attribute it to external factors 12
  13. 13. o Grade 4: Awareness present but attribute it to something unknown, acceptanceo Grade 5: Intellectual insight- Awareness present, attributes it to psychological causes but does not apply it to future experienceso Grade 6: True emotional insight 13
  14. 14. Case summary• Basic data and socio-economic profile• Presenting complaints (including HOPI)• Relevant past, family, developmental, occupational history etc.• Pre-morbid personality• Relevant M.S.E. findings• Relevant Physical examination findings• Diagnosis• Management 14

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