This document provides an overview of the components of a mental status examination (MSE). It describes 8 components that are assessed during an MSE: general appearance and behavior; speech; mood and affect; thought; perception; cognition; judgement; and insight. Each component is then defined and examples are provided of the types of observations, questions, and tests used to evaluate the patient's status in that area. The goal of the MSE is to obtain a comprehensive understanding of the patient's overall emotional and cognitive functioning.
Personality disorder ppt MENTAL HEALTH NURSINGvihang tayde
Most definition of normal personality includes some or all of the following features,
Present since adolescence.
Stable overtime despite fluctuations in mood.
Manifest in different environment.
Recognizable to friends and acquaintance.
hii guys this is my ongoing presentation from my speciality class i hope u guys lije that please so i hope it is been useful for u in ur specialities by getting little help with that
ADHD also known as hyperkinetic disorder is a common childhood disorder among school aged children that is characterised by persistent patterns of inattention, hyperactivity and impulsivity resulting in an underachievement in the school or work performance.
Personality disorder ppt MENTAL HEALTH NURSINGvihang tayde
Most definition of normal personality includes some or all of the following features,
Present since adolescence.
Stable overtime despite fluctuations in mood.
Manifest in different environment.
Recognizable to friends and acquaintance.
hii guys this is my ongoing presentation from my speciality class i hope u guys lije that please so i hope it is been useful for u in ur specialities by getting little help with that
ADHD also known as hyperkinetic disorder is a common childhood disorder among school aged children that is characterised by persistent patterns of inattention, hyperactivity and impulsivity resulting in an underachievement in the school or work performance.
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
SO GUYS ONCE AGAIN HERE I PRESENT U THE OWN MADE PRESENTATION ON THE TOPIC DEMENTIA I HOPE U LIKE THAT IT IS BEEN USEFUL U WHILE MAKING PSYCHIATRIC PRESENTATION
mania is an alteration in mood that is characterized by extreme happiness, extreme irritability, hyperactivity, little or no need for sleep. the main etiological factors include biological factors, biochemical influences, physiological factors, and psycho social theories. mania is broadly classified into three categories- hypo mania, acute mania and delirious mania. there are three types of treatment for mania- pharmacological treatment, psycho-social treatment and ECT.
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
SO GUYS ONCE AGAIN HERE I PRESENT U THE OWN MADE PRESENTATION ON THE TOPIC DEMENTIA I HOPE U LIKE THAT IT IS BEEN USEFUL U WHILE MAKING PSYCHIATRIC PRESENTATION
mania is an alteration in mood that is characterized by extreme happiness, extreme irritability, hyperactivity, little or no need for sleep. the main etiological factors include biological factors, biochemical influences, physiological factors, and psycho social theories. mania is broadly classified into three categories- hypo mania, acute mania and delirious mania. there are three types of treatment for mania- pharmacological treatment, psycho-social treatment and ECT.
Insight is one of the crucial components of a mental status examination in Psychiatry. Scarce data is available in the standard textbooks on this concept.
The following presentation was made after going through the myriad of articles and case studies i found online.
Approach to a case of Fever with altered sensoriumRoy Shilanjan
A brief description about the possible d/d of fever with alteration of sensorium and how to approach the diagnosis through systematic yet focused history taking , physical examination and lab and radiological investigations.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
2. MENTAL STATUS
Mental status is the total
expression of a person’s emotional
responses, mood, cognitive
function, and personality
3. COMPONENTS
1. General appearance and behaviour
2. Speech
3. Mood and affect
4. Thought
5. Perception
6. Cognition (higher mental functions)
7. Judgement
8. Insight
4. 1. GENERAL APPEARANCE AND BEHAVIOUR
a) General appearance:
Body build and physical appearance
(approxi-mate height, weight, and appearance)
Looks comfortable/uncomfortable
Physical health
Grooming
Hygiene
Self-care
Dressing (adequate, appropriate)
Facies (non-verbal expression of mood).
9. Psychological pillow
A sign of catatonia in which the patient holds her head a
few centimeters above the bed or pillow.
It is a symptom of catatonia and can last for many hours.
10. f. Social manner
Increased, decreased, or inappropriate.
g. Rapport
Whether a working empathic relationship can
be established with the patient, should
mentioned.
h. Hallucinatory behaviour:
o Smiling or crying without reason
o Muttering/ talking to self (non-social speech)
o Odd gesturing in response to auditory or visual
hallucinations.
11. 2. SPEECH
a. Rate and quantity of speech
Whether speech is present or absent
(mutism).
If present, whether it is spontaneous.
Productivity is increased or decreased.
Rate is rapid or slow.
Pressure of speech or poverty of speech.
b. Volume and tone of speech
Increased/decreased.
12. c. Flow and rhythm of speech
Smooth/hesitant.
Dysprosody.
Blocking (sudden).
Circumstantiality.
Tangentiality, loosening of associations.
Verbigeration, Perseveration
stereotypies (verbal).
Flight of ideas, clang associations.
Loosening of association
13. 3. MOOD AND AFFECT
Affect is outward expression of person’s current
feeling State
Mood is sustained Emotional State; Overall General
mood
In addition to non-verbal mood observed , the patient
is asked about present ‘mood.’ This is recorded as
subjective affect while the observed emotional
change is described as objective affect.
14. Mood is described as
Relaxed, Happy, Anxious, Angry,
– Depressed, Hopeless, Hopeful,
– Apathetic, Euphoric, Euthymic
(Normal/EvenMood),
– Elated, Irritable, Fearful, Silly
15. AFFECT AND MOOD
Affect: How do they appear to you?
Mood: asks the patient directly how
he/she feels
16. Examples
Mood is described as general warmth, euphoria,
elation, exaltation and ecstasy in mania
Anxious and restless in anxiety and depression;
Sad, irritable, angry and despaired in depression;
Shallow, blunted, indifferent, restricted, inappropriate
and labile in schizophrenia.
Anhedonia may occur in both schizophrenia and
depression
17. Questions to ask about mood
How do you generally feel most of the
time?
What's your mood like?
How would you say you feel generally -
happy, sad, frightened, angry?
22. 4. THOUGHT
a. Stream and form of thought:
Stream and form of thought’ overlaps with
examination of ‘speech.’
Spontaneity, productivity, flight of ideas, poverty of
content of speech, thought block
Continuity of thought is assessed.
Whether the thought processes are relevant to the
questions asked.
Any loosening of
associations, tangentiality, circumstantiality, illogical
thinking, perseveration, verbigeration is noted.
23. b. Content of thought:
Obsessions and contents of phobias; ideas
and delusions of persecution, reference,
grandeur, love, jealousy (infidelity), guilt,
nihilism, poverty
25. Questions about thought form
Do your thoughts seem faster than normal
Do you find you have lots and lots of
different thoughts?
Does your mind seem to be slowed down?
Do you ever have the experience when your
thoughts suddenly stop?
Do you ever feel that your mind is suddenly
wiped blank and you have no thoughts at
all?
26. Questions about delusions
Do you ever feel that people are following you?
Do you ever feel that people are seeking to harm
you in some way?
Do people spy on you?
Has anything strange or unusual been going on?
Is there anything special about yourself which makes
you different from other people?
Is there anything you can do which other people
can't?
Do you think that somebody has put a spell on you?
Is a spirit/djinn/demon causing problems for you?
27. Questions about thought insertion
Do you ever have thoughts in your mind which are not
your own?
Does anything else use your mind to think with?
Does anything put thoughts into your mind from
outside?
Where do those thoughts come from?
Questions about thought withdrawal
Does anything ever take your thoughts away?
Do you ever have your mind wiped blank?
Does anything take thoughts out of your mind so that
they're not there any more?
28. Questions about thought broadcast
Can other people tell what you are thinking?
Do your thoughts ever go out of your own mind?
Do your thoughts go out of your mind to other
people?
Are your thoughts ever put on the television or
radio?
Do your thoughts go out of your mind to
somewhere else?
29. 5. PERCEPTION:
a. Hallucinations:
Auditory, visual, olfactory, gustatory or tactile
Auditory hallucinations should be further enquired
-what was heard
-how many voices were heard
-in which part of the day-
-male or female voices
-how interpreted and whether second person or third
person hallucinations (i.e., whether the voices are
addressing the patient or are discussing him in third
person).
30. b. Illusions and misinterpretations: Whether
visual, auditory, or in other sensory fields;
whether occur in clear consciousness or not.
c. Depersonalization and derealization.
d. Somatic passivity phenomenon:
Strange sensations imposed by ‘somebody.’
e. Others:
Autoscopy, abnormal vestibular sensations,
sense of presence should be noted here.
32. 6. COGNITION OR NEUROPSYCHIATRIC
ASSESSMENT
a) Consciousness
b) Orientation
c) Attention
d) Concentration
e) Memory
f) Intelligence
g) Abstract thinking
33. a. Consciousness
Conscious/confusion/clouding/delirium/stupor/coma.
Any disturbance of consciousness should be rated on
Glasgow Coma Scale.
b. Orientation:
Whether the patient is well oriented to
time
(time, date, day, month, year, season, time spent in
hospital)
place
(where is he, location, where does he stay) and
person
(his own name, can he identify people around him and
their role in setting).
34. c. Attention: Is the attention easily aroused and
sustained. Ask the patient to repeat digits forwards
backwards.
35. d. Concentration:
Can the patient concentrate
Ease of distractibility
Ask to subtract serial sevens from hundred
(100-7 test), or serial threes from forty (40-3
test), or to count backwards from 20, or
enumerate the names of the months (or days
of the week) in the reverse order.
Note down the answers and the time take
perform the tests.
36. e. Memory
Immediate retention and recall (IR and R):
Recent
How did the patient come to the room/hospital;
what he ate for dinner the day before or for breakfast
the same morning.
Remote:
Ask for the date of marriage
name and birthdays of children
any other relevant questions from the person’s past.
Note any amnesia (anterograde/retrograde),
confabulation, if present.
37. QUESTIONS TO ASK FOR MEMORY
Long-term memory:
Where did you live when you were growing
up?
What was the name of the school you went
to?
Short-term memory:
What did you have for breakfast?
What did you do yesterday?
38. f. Intelligence:
Ask questions about general information,
keeping in mind the patient’s educational and
social background, his experiences and interests
e.g., ask about
o the current and the past prime ministers and
presidents of India
o the capital of India, and
o the name of the various states.
Test for reading and writing.
Give simple tests of calculation.
39. g. Abstract thinking:
Abstract thinking testing assesses patient’s
concept formation.
The methods used are:
Proverb testing: Asking the meaning of
simple proverbs.
Similarities (and also the differences)
between familiar objects, like: table and chair;
banana and orange; dog and lion; eye and ear.
differences
40. Similarities:
What do the following have in common?
Chair and desk?
Apple and pear?
Poem and statue?
Proverbs: What do people mean when they
say…..?
Don’t cry over spilled milk
A rolling stone gathers no moss
When the cat’s away the mice will play
41. 7. JUDGEMENT
Personal judgment
Social judgment
is observed during the hospital stay and during the
interview session.
Test judgment
is assessed by asking the patient what he would do
in certain test situations, like ‘a house on fire’, or ‘a
man lying on the road’, or ‘a
sealed, stamped, addressed envelope lying on a
street’.
Judgment is rated as Good/Intact/Normal or
43. LEVELS OF INSIGHT
Insight is rated on a 6-point scale from one to six
1) Complete denial of illness
2) Slight awareness of being sick & needing
help but denying it at the same time
3) Awareness of being sick but blaming it on
others, on external factors, or on organic
factors.
4) Awareness that illness is due to something
unknown in the patient
5) Intellectual insight
6) True emotional insight