Podcast
Questions and Answers
Which of the following best describes the primary reason the patient's family sought medical consultation?
Which of the following best describes the primary reason the patient's family sought medical consultation?
- The patient's increasingly bizarre behavior over the past 6 months, including talking to unseen objects and sleep deprivation. (correct)
- The patient's history of cannabis use and previous diagnosis of schizophrenia.
- The patient's refusal to show his diary, which they believe contains incriminating information.
- The patient's complaints of hearing the voice of God and his subsequent communication with parliament.
Considering the patient's belief that he is receiving instructions from God to create new laws, which of the following best describes this symptom?
Considering the patient's belief that he is receiving instructions from God to create new laws, which of the following best describes this symptom?
- Delusion of grandeur (correct)
- Thought insertion
- Auditory hallucination
- Delusion of persecution
During the mental state examination, the clinician finds it challenging to extract coherent information from the patient, and his speech appears nonsensical. Which of the following terms best characterizes this?
During the mental state examination, the clinician finds it challenging to extract coherent information from the patient, and his speech appears nonsensical. Which of the following terms best characterizes this?
- Circumstantiality
- Word salad (correct)
- Tangentiality
- Neologism
Given the patient's presentation, which combination of symptoms most strongly supports a diagnosis of schizophrenia?
Given the patient's presentation, which combination of symptoms most strongly supports a diagnosis of schizophrenia?
The patient's lack of awareness that he has a problem is a common symptom in psychiatric disorders. Which term best describes this lack of awareness?
The patient's lack of awareness that he has a problem is a common symptom in psychiatric disorders. Which term best describes this lack of awareness?
Considering the patient's excessive writing in a diary, what would be the most important factor to consider when evaluating this behavior as a potential symptom of a mental disorder?
Considering the patient's excessive writing in a diary, what would be the most important factor to consider when evaluating this behavior as a potential symptom of a mental disorder?
If the patient refuses to cooperate during the mental state examination, what would be the most appropriate next step for the clinician?
If the patient refuses to cooperate during the mental state examination, what would be the most appropriate next step for the clinician?
Upon noticing the patient talking to himself, what would be the most important aspect to assess in order to differentiate a hallucination from normal self-talk?
Upon noticing the patient talking to himself, what would be the most important aspect to assess in order to differentiate a hallucination from normal self-talk?
How does a patient's understanding of their illness fundamentally impact their decision-making capacity and overall behavior?
How does a patient's understanding of their illness fundamentally impact their decision-making capacity and overall behavior?
Why is the mental status exam considered a critical assessment tool in healthcare?
Why is the mental status exam considered a critical assessment tool in healthcare?
During a consultation, how should a healthcare provider administer and use the mental status exam to effectively assess a patient?
During a consultation, how should a healthcare provider administer and use the mental status exam to effectively assess a patient?
Which aspect of a patient's presentation provides insights into their self-care, socio-economic status, and potential mental state?
Which aspect of a patient's presentation provides insights into their self-care, socio-economic status, and potential mental state?
Why is assessing the reliability of a patient's responses important during a mental state examination, particularly in the context of making a diagnosis?
Why is assessing the reliability of a patient's responses important during a mental state examination, particularly in the context of making a diagnosis?
How do thought form and content differ in the context of a mental state examination, and why is it important to evaluate both?
How do thought form and content differ in the context of a mental state examination, and why is it important to evaluate both?
Which of the following best describes the primary utility of cognitive screening tools like the Mini-Mental State Examination (MMSE)?
Which of the following best describes the primary utility of cognitive screening tools like the Mini-Mental State Examination (MMSE)?
A 34-year-old male is referred due to strange behavior over the past six months. How can the mental status examination aid in understanding this patient's condition?
A 34-year-old male is referred due to strange behavior over the past six months. How can the mental status examination aid in understanding this patient's condition?
A patient firmly believes he receives direct instructions from a divine entity, which he meticulously records to establish new laws. Despite the implausibility, he shows no doubt or concern. Which of the following best describes this presentation?
A patient firmly believes he receives direct instructions from a divine entity, which he meticulously records to establish new laws. Despite the implausibility, he shows no doubt or concern. Which of the following best describes this presentation?
A patient with a history of schizophrenia and recent cannabis use exhibits disorganized speech, rambling about a relationship with a divine entity. Aside from disorganized speech, which additional symptom is most indicative of a thought disorder?
A patient with a history of schizophrenia and recent cannabis use exhibits disorganized speech, rambling about a relationship with a divine entity. Aside from disorganized speech, which additional symptom is most indicative of a thought disorder?
A patient with schizophrenia hears a voice that they identify as a divine entity, providing instructions. Which of the following is the most crucial differentiating factor between a hallucination and a delusion in this scenario?
A patient with schizophrenia hears a voice that they identify as a divine entity, providing instructions. Which of the following is the most crucial differentiating factor between a hallucination and a delusion in this scenario?
During a mental state examination, a patient with suspected schizophrenia exhibits poor insight and judgment, alongside disorganized speech and delusions. How does impaired insight directly contribute to diminished judgment in this context?
During a mental state examination, a patient with suspected schizophrenia exhibits poor insight and judgment, alongside disorganized speech and delusions. How does impaired insight directly contribute to diminished judgment in this context?
The patient's presentation includes auditory hallucinations, delusions, disorganized speech and behaviour and poor insight and judgement. Considering the potential impact of cannabis use on mental state, how does this complicate the assessment?
The patient's presentation includes auditory hallucinations, delusions, disorganized speech and behaviour and poor insight and judgement. Considering the potential impact of cannabis use on mental state, how does this complicate the assessment?
Your patient has been using cannabis for the last year and was previously told that he has schizophrenia. He admits to hearing the voice of God who is instructing him to observe everyone and write it all down in his diary as it will become the law on completion. Which of the following differential diagnoses should be ruled out first?
Your patient has been using cannabis for the last year and was previously told that he has schizophrenia. He admits to hearing the voice of God who is instructing him to observe everyone and write it all down in his diary as it will become the law on completion. Which of the following differential diagnoses should be ruled out first?
A patient is diagnosed with schizophrenia based on their symptoms of disorganized speech and thoughts, abnormal psychomotor behavior, and poor insight and judgment. Which of the following best illustrates the concept of 'abnormal psychomotor behavior' in this context?
A patient is diagnosed with schizophrenia based on their symptoms of disorganized speech and thoughts, abnormal psychomotor behavior, and poor insight and judgment. Which of the following best illustrates the concept of 'abnormal psychomotor behavior' in this context?
The patient described is unkempt and disheveled, which is noted during the examination. Which aspect of the comprehensive assessment does evaluating the patient's appearance primarily contribute to?
The patient described is unkempt and disheveled, which is noted during the examination. Which aspect of the comprehensive assessment does evaluating the patient's appearance primarily contribute to?
A patient expresses a firm belief that a neighbor is intentionally sabotaging their garden, despite evidence to the contrary. While this belief causes them significant distress, it doesn't dominate their thoughts. Which of the following thought content disturbances is MOST consistent with this presentation?
A patient expresses a firm belief that a neighbor is intentionally sabotaging their garden, despite evidence to the contrary. While this belief causes them significant distress, it doesn't dominate their thoughts. Which of the following thought content disturbances is MOST consistent with this presentation?
A patient rigidly believes that their thoughts can directly influence world events, leading them to perform specific rituals to prevent catastrophes. Although highly distressing, the patient acknowledges this belief is likely irrational. Which of these options is the MOST accurate description of their symptoms?
A patient rigidly believes that their thoughts can directly influence world events, leading them to perform specific rituals to prevent catastrophes. Although highly distressing, the patient acknowledges this belief is likely irrational. Which of these options is the MOST accurate description of their symptoms?
During a psychiatric assessment, a patient abruptly shifts from describing childhood memories to detailing complex conspiracy theories involving government surveillance, displaying pressured speech and tangential associations. Which combination of thought and speech disturbances BEST describes this presentation?
During a psychiatric assessment, a patient abruptly shifts from describing childhood memories to detailing complex conspiracy theories involving government surveillance, displaying pressured speech and tangential associations. Which combination of thought and speech disturbances BEST describes this presentation?
A patient who demonstrates flat affect consistently reports feeling overwhelmed with anxiety and sadness. Which of the following BEST describes this discrepancy?
A patient who demonstrates flat affect consistently reports feeling overwhelmed with anxiety and sadness. Which of the following BEST describes this discrepancy?
A patient displays an unwavering belief that they are the secret child of a famous celebrity and are destined to inherit their empire, despite lacking any evidence. This belief is NOT shared by others, and the patient remains firm on it, regardless of what anyone says. What type of delusion is the patient experiencing?
A patient displays an unwavering belief that they are the secret child of a famous celebrity and are destined to inherit their empire, despite lacking any evidence. This belief is NOT shared by others, and the patient remains firm on it, regardless of what anyone says. What type of delusion is the patient experiencing?
A patient consistently uses invented words and phrases during conversation, making it difficult to understand the meaning of their speech. What disturbance of thought form is the patient MOST likely exhibiting?
A patient consistently uses invented words and phrases during conversation, making it difficult to understand the meaning of their speech. What disturbance of thought form is the patient MOST likely exhibiting?
A patient describes an event where they believe a radio broadcast was sending them a secret, personalized message about an impending crisis. What type of delusion is the patient MOST likely experiencing?
A patient describes an event where they believe a radio broadcast was sending them a secret, personalized message about an impending crisis. What type of delusion is the patient MOST likely experiencing?
A patient reports a persistent feeling of emptiness and detachment from the world, expressing a belief that they and everything around them are not real. Which type of delusion is MOST consistent with these symptoms?
A patient reports a persistent feeling of emptiness and detachment from the world, expressing a belief that they and everything around them are not real. Which type of delusion is MOST consistent with these symptoms?
A patient, when asked about their plans for the day, provides excessive and unnecessary details about irrelevant topics before eventually returning to the original question. This pattern of speech is BEST described as:
A patient, when asked about their plans for the day, provides excessive and unnecessary details about irrelevant topics before eventually returning to the original question. This pattern of speech is BEST described as:
A patient is unable to recall events from the past week but can vividly describe childhood experiences. Which memory disturbance BEST aligns with this presentation?
A patient is unable to recall events from the past week but can vividly describe childhood experiences. Which memory disturbance BEST aligns with this presentation?
A patient consistently recounts detailed stories from their past that are demonstrably false, despite the absence of any intent to deceive. This is MOST characteristic of:
A patient consistently recounts detailed stories from their past that are demonstrably false, despite the absence of any intent to deceive. This is MOST characteristic of:
A patient exhibits a complete lack of emotional expression, maintaining a blank facial expression and speaking in a monotone voice, regardless of the topic being discussed. This is BEST described as:
A patient exhibits a complete lack of emotional expression, maintaining a blank facial expression and speaking in a monotone voice, regardless of the topic being discussed. This is BEST described as:
A patient who experienced a traumatic brain injury is unable to learn new information but can recall events from before the injury. What type of memory impairment is the patient MOST likely experiencing?
A patient who experienced a traumatic brain injury is unable to learn new information but can recall events from before the injury. What type of memory impairment is the patient MOST likely experiencing?
Compared to 'blunted affect', 'flat affect' is:
Compared to 'blunted affect', 'flat affect' is:
A patient expresses excessive happiness, inflated self-esteem, and a decreased need for sleep. They are extremely talkative, easily distracted and involved in multiple projects simultaneously. Which of the following terms BEST describes this patient's mood?
A patient expresses excessive happiness, inflated self-esteem, and a decreased need for sleep. They are extremely talkative, easily distracted and involved in multiple projects simultaneously. Which of the following terms BEST describes this patient's mood?
Which of the following best illustrates a disturbance in thought form, rather than thought content?
Which of the following best illustrates a disturbance in thought form, rather than thought content?
A patient describes seeing sounds as colors. Which of the following perceptual disturbances is MOST likely being experienced?
A patient describes seeing sounds as colors. Which of the following perceptual disturbances is MOST likely being experienced?
A patient is unable to provide their name, date of birth, or current location. Which of the following terms BEST describes this condition?
A patient is unable to provide their name, date of birth, or current location. Which of the following terms BEST describes this condition?
In what way does a hallucination differ fundamentally from an illusion?
In what way does a hallucination differ fundamentally from an illusion?
Which of the following represents the MOST accurate differentiation between attention and concentration?
Which of the following represents the MOST accurate differentiation between attention and concentration?
A patient rapidly shifts from discussing their upcoming vacation to their childhood pets, then to a news story they recently heard, with no apparent connection between topics. Which thought process disturbance is MOST evident?
A patient rapidly shifts from discussing their upcoming vacation to their childhood pets, then to a news story they recently heard, with no apparent connection between topics. Which thought process disturbance is MOST evident?
In the context of psychopathology, what is the clinical significance of 'poor insight and judgement'?
In the context of psychopathology, what is the clinical significance of 'poor insight and judgement'?
A patient consistently uses words like 'gloomification' and 'happerstance' during conversation. These words are not found in any dictionary and their meaning is unclear. Which disturbance is MOST likely being exhibited?
A patient consistently uses words like 'gloomification' and 'happerstance' during conversation. These words are not found in any dictionary and their meaning is unclear. Which disturbance is MOST likely being exhibited?
A patient being interviewed begins to describe their childhood but includes excessive and unnecessary details about irrelevant events, eventually returning to the original topic. Which of the following is the MOST likely thought process disturbance?
A patient being interviewed begins to describe their childhood but includes excessive and unnecessary details about irrelevant events, eventually returning to the original topic. Which of the following is the MOST likely thought process disturbance?
Which of the following scenarios BEST exemplifies the psychopathological symptom of 'hypervigilance'?
Which of the following scenarios BEST exemplifies the psychopathological symptom of 'hypervigilance'?
A patient in a psychiatric unit is observed echoing the questions posed to them by the psychiatrist. Which of the following thought and speech disturbances BEST corresponds to this behavior?
A patient in a psychiatric unit is observed echoing the questions posed to them by the psychiatrist. Which of the following thought and speech disturbances BEST corresponds to this behavior?
A doctor asks the patient how they are feeling, and the patient responds 'The train is never on time, apples don't grow on trees, the color blue is feeling talkative today.' Which of the following conditions is the patient MOST likely exhibiting?
A doctor asks the patient how they are feeling, and the patient responds 'The train is never on time, apples don't grow on trees, the color blue is feeling talkative today.' Which of the following conditions is the patient MOST likely exhibiting?
A patient is describing their beliefs about being a messenger from another planet, but when prompted for specific details, they avoid directly answering. Instead, they provide loosely related information, never actually addressing the question. Which of the following thought disturbances does this exemplify?
A patient is describing their beliefs about being a messenger from another planet, but when prompted for specific details, they avoid directly answering. Instead, they provide loosely related information, never actually addressing the question. Which of the following thought disturbances does this exemplify?
After being asked a question, a patient suddenly stops talking mid-sentence and stares blankly into space, unable to recall what they were saying. Which of the following phenomena does this describe?
After being asked a question, a patient suddenly stops talking mid-sentence and stares blankly into space, unable to recall what they were saying. Which of the following phenomena does this describe?
A patient reports that objects appear much smaller than they actually are. Which of the following perceptual disturbances BEST describes this phenomenon?
A patient reports that objects appear much smaller than they actually are. Which of the following perceptual disturbances BEST describes this phenomenon?
Which of the following represents the most likely primary diagnosis based on the patient's reported symptoms and history?
Which of the following represents the most likely primary diagnosis based on the patient's reported symptoms and history?
The patient's belief that he is receiving instructions from God to record information that will become law is best described as what type of delusion?
The patient's belief that he is receiving instructions from God to record information that will become law is best described as what type of delusion?
What is the most appropriate initial approach to managing this patient's acute symptoms, considering his lack of insight and increasing agitation?
What is the most appropriate initial approach to managing this patient's acute symptoms, considering his lack of insight and increasing agitation?
Which of the following is the MOST important factor to consider when assessing the potential impact of cannabis use on this patient's presentation?
Which of the following is the MOST important factor to consider when assessing the potential impact of cannabis use on this patient's presentation?
When considering the differential diagnosis, what other condition should be highly considered given the patient's auditory hallucinations, disorganized thoughts and speech, and deteriorating behavior?
When considering the differential diagnosis, what other condition should be highly considered given the patient's auditory hallucinations, disorganized thoughts and speech, and deteriorating behavior?
Which of the following family interventions would be LEAST helpful in supporting this patient's treatment and recovery?
Which of the following family interventions would be LEAST helpful in supporting this patient's treatment and recovery?
What legal and ethical considerations are MOST pertinent in this case, given the patient's presentation and potential risk to himself or others?
What legal and ethical considerations are MOST pertinent in this case, given the patient's presentation and potential risk to himself or others?
Which of the following medication classes would be the MOST appropriate FIRST-LINE treatment option for the positive symptoms?
Which of the following medication classes would be the MOST appropriate FIRST-LINE treatment option for the positive symptoms?
Flashcards
Hallucinations
Hallucinations
Sensory perceptions that occur without external stimuli; can be auditory, visual, olfactory, gustatory, or tactile.
Delusions
Delusions
Fixed, false beliefs that are not amenable to change in light of conflicting evidence.
Agitation
Agitation
A state of agitation, restlessness, and sometimes aggression, often accompanied by increased motor activity.
Lack of Insight
Lack of Insight
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Mental State Exam
Mental State Exam
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Nonsensical Speech
Nonsensical Speech
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Symptom Cluster
Symptom Cluster
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Signs (Psychiatric)
Signs (Psychiatric)
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Disorganized Symptoms
Disorganized Symptoms
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Psychopathology
Psychopathology
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Consciousness
Consciousness
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Attention
Attention
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Concentration
Concentration
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Delirium
Delirium
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Disoriented
Disoriented
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Stuporous
Stuporous
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Distractible
Distractible
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Hypervigilant
Hypervigilant
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Illusion
Illusion
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Micropsia
Micropsia
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Circumstantiality
Circumstantiality
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Flight of Ideas
Flight of Ideas
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Appearance (MSE)
Appearance (MSE)
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Motor Behavior (MSE)
Motor Behavior (MSE)
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Attitude towards examiner
Attitude towards examiner
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Reliability (MSE)
Reliability (MSE)
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Level of Consciousness
Level of Consciousness
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Speech (MSE)
Speech (MSE)
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MMSE
MMSE
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Auditory Hallucinations
Auditory Hallucinations
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Disorganized Behavior
Disorganized Behavior
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Delusions of Grandeur
Delusions of Grandeur
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Poor Self-Care
Poor Self-Care
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Suspiciousness
Suspiciousness
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Disorganized Speech
Disorganized Speech
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Lack of Awareness
Lack of Awareness
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Loosening of Associations
Loosening of Associations
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Neologisms
Neologisms
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Magical Thinking
Magical Thinking
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Poverty of Thought Content
Poverty of Thought Content
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Ideas of Reference
Ideas of Reference
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Bizarre Delusions
Bizarre Delusions
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Persecutory Delusions
Persecutory Delusions
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Mood
Mood
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Affect
Affect
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Dysphoric
Dysphoric
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Anhedonia
Anhedonia
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Amnesia
Amnesia
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Confabulation
Confabulation
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Disorganized Presentation
Disorganized Presentation
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Poor Insight
Poor Insight
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Poor Judgement
Poor Judgement
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History Taking
History Taking
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Insight Assessment
Insight Assessment
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Study Notes
Introduction to Psychopathology: The Language of Psychiatry
- The lecture introduces psychopathology, which is essential for recognizing diagnoses and understanding clinical presentations.
- Understanding psychiatric terminology and language facilitates communication among healthcare professionals.
Overview of Lecture
- Lecture covers an introductory case vignette, psychiatric symptom clusters and signs of disturbances, and a case vignette discussion
Case Vignette
- A 34-year-old male is referred by family due to strange behavior over the past 6 months.
- He talks to unseen objects, rarely sleeps, and excessively writes in a diary he keeps private.
- He hasn't bathed in a week, distrusts food, and denies having a problem.
On Further Enquiry
- The patient has been using cannabis for a year and was previously told he has schizophrenia.
- He reports hearing God's voice, instructing him to record observations to establish a future law.
- The patient sent his actions and God's instructions to parliament, finding nothing strange.
Your Findings
- Initially calm, the patient becomes agitated when questioned further.
- His speech is nonsensical and uninformative, focusing on his relationship with God.
- He talks to himself during the consultation, and doesn't believe anything is wrong.
Assessment
- The patient is assessed as having schizophrenia.
- Supporting signs and symptoms include hallucinations and delusions.
- Examination findings reveal a disorganised appearance, speech, and thoughts, abnormal psychomotor behavior, and poor insight and judgement.
The Language of Psychopathology
- Psychopathology describes abnormalities in thinking, beliefs, mood, behavior, and cognitive functioning.
- A psychiatric diagnosis can be made by looking for patterns in a constellation of signs and symptoms.
Disturbances of Consciousness
- Consciousness definitions: Being aware of and having knowledge of surroundings and environment.
- Occurs on a continuum with fully alert on one end and unconscious on the other.
- Attention is the ability to mentally attend to and focus on one or more aspects of the environment.
- Concentration is sustained focus or attention to a task or environment aspect.
- Delirium, due to a medical cause, involves a disturbance of cognitive functioning with impaired awareness and attention to surroundings.
Disturbances of Consciousness - Psychopathology Terms
- Disorientated: Not fully aware of place(s), time, or personal information.
- Stuporous: Not fully awake or aware of surroundings.
- Impaired attention: Lacking complete or full attention.
- Distractible: Attention is easily diverted.
- Hypervigilant: Overly focused on a particular environmental aspect, neglecting others.
Disturbances of Perception
- Perception is a complex process aiming to make sense of physical/environmental stimuli.
- Illusions are misperceptions of real sensory stimuli, while hallucinations are sensory perceptions without external stimuli.
Disturbances of Perception - Psychopathology
- Types of illusions involve the five sensed:
- Micropsia vs macropsia: Incorrect perception that objects are either larger or smaller than they are in reality.
- Synaesthesia: Sensory modalities become cross-wired and combined.
- Types of hallucinations also involve the five senses, for example:
- Auditory hallucinations: Hear voices.
- Visual hallucinations: Seeing dead people
- Olfactory hallucinations.
- Gustatory hallucinations.
- Tactile hallucinations: Feeling strange sensations.
Disturbances of Thought Form and Content
- Thought includes ideational experiences as opposed to emotive experiences.
- Rational thought is goal directed, logically associates concepts, and is reality-oriented.
- Thought form disturbances are problems in how thoughts are put together and expressed.
- Thought content disturbances are problems with the ideas being thought about and expressed.
Disturbances of Thought Form and Content - Psychopathology
- Thought form disturbances involve problems in how thoughts are sequenced such as:
- Circumstantiality involves unnecessary detail.
- Tangentiality is where one veers off topic.
- Derailment/loosening of associations are where ideas and topics are unrelated.
- Thought blocking is a sudden stop in the flow of thoughts/speech.
- Echolalia is the echoing/repeating the words of another.
- Flight of ideas involves thoughts and speech jumping, often distracted by stimuli.
- Incoherence is illogical and hard to follow.
- Irrelevance is a response unrelated to the current topic.
- Word salad involves nonsensical jumbles of words with no sense.
- Neologisms are newly formed words/expressions that do not have a clear prior establishment.
Disturbances of Thought Form and Content - Examples
- Loosening of associations includes seemingly random facts that have little to no relation to one another.
- Flight of ideas is where a person constantly switches topics due to random mental images.
- Neologisms are invented words of the speaker.
Disturbances of Thought Form and Content - Psychopathology Continued
- Thought content disturbances are problems with the ideas themselves.
- Delusions are fixed, false beliefs one firmly holds.
- Magical thinking involves superstitious thought patterns.
- Poverty of thought content involves lacking detail and richness in thought.
- Overvalued ideas are strongly held but not delusional beliefs.
- Fantasy involves imaginary/wishful thinking that is unrealistic.
- Phobias involve extreme irrational fears.
- Obsessions involve intrusive thoughts that lead to distress.
- Ideas of reference entail where real things have a special significance to an individual.
Types of Delusions
- Control entails one's body, mind, or actions being controlled by another.
- Bizarre delusions are outright impossible.
- Grandiose delusions are marked by a belief of high status.
- Nihilistic delusions include the idea that individual/others/the world is nonexistent.
- Religiose delusions involve religious concepts eg: Jesus, or God
- Persecutory delusions are where one believes that someone is out to get them.
- Referential delusions includes the idea that unrelated events are specially significant to an individual.
- Somatic delusions involve aspects of the body.
Disturbances of Speech and Language
- It describes how thoughts, ideas and emotions get expressed
- Speech and language disturbances can have multiple sources such as:
- Too much speech: Too much and unnecessary details.
- Too little speech: Poverty of it.
- Quality of speech: Can be loud, soft, monotonous or staccato.
Disturbances of Mood and Affect
- Mood is the sustained subjective internal experience of emotion.
- Affect is the external representation/expression of the internal mood/emotion.
Disturbances of Mood - Psychopathology
-
Descriptors for mood include:
- Euthymic: 'Normal' or stable.
- Dysphoric: Uneasy or "not normal".
- Elevated: Overly happy or happier than normal.
- Expansive: Boisterous, over friendly and loud.
- Euphoric: Overly excited.
- Depressed.
- Irritable.
Disturbances of Affect - Psychopathology
-
Descriptors of affect involve describing affect such as:
- Appropriate/congruent: When current mood is expressed and matches.
- Inappropriate/incongruent: When current mood is not expressed and doesn't match.
- Labile - unstable affect where moods change very very quickly.
- Flat - No reaction.
- Blunted - worse than restricted.
- Restricted - restricted range of facial expression.
- Reactive
Disturbances of Mood and Affect Continued
-
Other ways mood can be described as:
- Anxious/fearful.
- Anhedonia - unable to feel pleasure or lack of interest.
- Alexithymia - The inability to express emotions in the self or in others.
Memory and Learning Disturbances
- Forming memories - attention, registration, understanding, retention and finally recall.
- Types or levels of memory involves:
- Immediate memories: Seconds to minutes of having some thought.
- Short term/recent memories: Hours to days of having some thought.
- Long term memories: Over multiple years of having some thought.
- Working memory: Manipulating old information to recall later on.
- Memory disturbances involves:
- Amnesia - anterograde vs retrograde, selective vs global.
- Confabulation - "filling in the gaps" with made up memories.
- Pseudodementia - memory losses or cognitive problems because of some structural or psychological problem.
Motor Disturbances
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Motor functioning requires ability to plan, initiate, and appropriately execute an action.
-
Motor disturbances range from:
- Too much movement - Psychomotor agitated.
- Too little movement - Psychomotor retarded.
-
Abnormal movements:
- Tremor, gesticulation - Quite serious and life threatening disorder.
- Catatonia - syndrome with many motor function problems.
Motor Disturbances - Psychopathology
-
Forms of abnormal activities:
- Tics - sudden short lived involuntary movements/actions/vocalizations.
- Mannerisms - repetitive body quirks.
- Automatism - automatically doing something without realizing.
- Stereotypical movements - bizarre, repetitive and purposeless movements.
- Akathisia - A subjective desire to be physically active.
- Mutism - Loss of speech.
- Echopraxia - A sudden urge to mimic the actions of another.
Insight and Judgement
- Insight: the ability to comprehend and reflect on the characteristics and significance of one's affliction or symptoms.
- Judgement: the capacity to act logically, make sound decisions, and take appropriate.
- If judgment is good then the other will be too.
Mental State Exam
- Equivalent to physical exam.
- Appearance – dishevelled/unkempt, neat dress, flamboyant.
- Motor behavior - increased or decreased
- Attitude toward examiner - suspicious, cooperative, passive etc.
- Reliability - ability to test data.
- Level of consciousness - hyperalert, alert, clouded, stuporous, coma. Speech - rate, flow, pressure.
- Communication - easy to engage, blocks, incoherent.
- Mood - the prevailing emotional tone.
- Affect - outward expression of emotions.
- Perceptual disturbances - hallucinations, delusions.
- Thought - process and content.
- Higher cognitive functioning.
- Judgment.
Folstein's Mini Mental Exam
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The Mini Mental State Examination (MMSE) is a brief, standardized questionnaire used to assess cognitive functions.
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Used in medical and psychiatric settings to screen for cognitive impairment and dementia.
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Assesses cognitive domains such as: Orientation, registration, attention, calculation, recall, language, visuospatial skills
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The MMSE is a snapshot of cognitive function:
- Serial examination is important;
- Cannot substitute for a complete cognitive evaluation;
- Used to track cognitive changes over time, evaluate treatment response, and aid in diagnosis.
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- Disorganized behavior.
- Delusions.
- Hallucinations.
- Appearance.
- Attitude and motor behavior.
- Thought disorder.
- Insight.
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