Podcast
Questions and Answers
What is the term used for any unusual rhythms or accent changes in speech?
What is the term used for any unusual rhythms or accent changes in speech?
What is the term for the disturbance in form of thought characterized by inability to distinguish reality from fantasy?
What is the term for the disturbance in form of thought characterized by inability to distinguish reality from fantasy?
Psychosis
What is the term for false sensory perceptions not based on reality?
What is the term for false sensory perceptions not based on reality?
Hallucination
Auditory hallucinations instruct the patient to act in specific ways.
Auditory hallucinations instruct the patient to act in specific ways.
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What is the primary purpose of a psychiatric assessment?
What is the primary purpose of a psychiatric assessment?
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What are some factors influencing psychiatric assessment? (Select all that apply)
What are some factors influencing psychiatric assessment? (Select all that apply)
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What does the term Jamais Vu refer to?
What does the term Jamais Vu refer to?
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Hyperactivity refers to abnormally excessive activity.
Hyperactivity refers to abnormally excessive activity.
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What is Hyperthymesia?
What is Hyperthymesia?
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Catatonia involves a lack of will to ______ or ______.
Catatonia involves a lack of will to ______ or ______.
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Match the following motor behaviors with their descriptions:
Match the following motor behaviors with their descriptions:
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What is Amnesia?
What is Amnesia?
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Which term best describes the filling of gaps in memory by imagining or false experiences?
Which term best describes the filling of gaps in memory by imagining or false experiences?
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Intellectual Insight involves admitting illness and acknowledging failures due to irrational feelings.
Intellectual Insight involves admitting illness and acknowledging failures due to irrational feelings.
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What are some common adjectives used to describe mood?
What are some common adjectives used to describe mood?
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What does the term 'mood' refer to in the context of the patient?
What does the term 'mood' refer to in the context of the patient?
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What is the term used for intense elation with feelings of grandeur?
What is the term used for intense elation with feelings of grandeur?
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Anhedonia is characterized by intense feelings of rapture.
Anhedonia is characterized by intense feelings of rapture.
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____ is a normal range of mood.
____ is a normal range of mood.
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Match the following terms to their descriptions:
Match the following terms to their descriptions:
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Study Notes
Psychiatric Assessment
- A process of collecting, organizing, and analyzing data or information about the client to identify manifestations
- Also known as Psychosocial assessment with mental assessment
- An integral and essential skill to develop, usually performed by psychologists
- Purposes:
- To construct a clear picture of the client's emotional state, mental capacity, and behavioral functions
- To serve as a basis for planning to meet the client's needs
- To evaluate the effectiveness of treatment and interventions
Mental Status Examination
- An integral and essential skill to develop, focusing on thought, behavior, and errands
- An accurate MSE helps elicit signs and symptoms of apparent mental illness and associated risk factors
- A structured tool and process that allows observers to assess the patient's current mental state
- Purposes:
- To construct a clear picture of the client's emotional state, mental capacity, and behavioral functions
- To identify signs and symptoms of apparent mental illness and associated risk factors
Factors Influencing Assessment
- Client's participation and feedback
- Client's health status
- Previous experience and misconception about healthcare
- Client's ability to understand
Kinds/Types of Data
- Objective: perceived by the nurse
- Subjective: kinocollect, inaanalyze
Mental Status Examination Components
- Posture and poise
- Gait
- Clothing type
- Hair and grooming
- Hygiene
- Appearance
- Motor behavior
- Negativism
- Mannerism
- Mutism
- Catatonia
- Hyperactivity
- Hypoactivity
- Tic
- Compulsive
- Aggression
- Attitude towards examiner
Mood and Affect
- Mood: a pervasive and sustained emotion subjectively experienced by the client
- Affect: the expression of emotion as seen by others
- Types of mood:
- Euthymic: normal range of mood
- Irritable: easily annoyed or provoked by anger
- Elevated: more cheerful than normal with a sense of confidence and joy
- Depressed: psychopathologic feeling of sadness
- Anhedonia: loss of interest and withdrawal from pleasurable activities
- Grief: sadness appropriate to a real loss
- Types of affect:
- Constricted: clear, decreased in range and intensity
- Blunted: emotional expression further reduced
- Flat: no affective expression, monotonous voice
- Bizarre: odd, illogical, grossly inappropriate, or unfounded
- Appropriate: the patient's emotional response is in context with the subject being discussed### Expression of Grandeur
- May or may not be congruent with the mood
- Inappropriate affect for a quality of response found in some schizophrenia patients, where the patient's affect is incongruent with what they are saying
Quality of Affect
- Is the patient sad (dysphoric), agitated, euphoric, or neutral?
- Dysphoric means sad, while euphoric means extremely happy
- Flat affect means no emotional expression, monotonous voice, and no visible expression
Fluctuation of Affect
- Labile means sudden change of mood
- Intensity of affect can be normal, full, broad, or reduced
Speech
- Describe speech in terms of quantity, rate, production, and quality
- Pressured speech means rapid speech, increased amount, and difficult to interrupt
- Povert of speech means restricted amount, usually monosyllabic
- Stuttering means frequent repetition of prolonged sound syllable
Appropriateness of Affect
- Considered in context of what patient is discussing
- Appropriate affect means emotion is in harmony with what is being discussed
- Inappropriate affect means disharmony with emotion and thought/speech
Sensory Aphasia
- Cannot understand right, even if they can speak
- Paucity of content means they do not want to speak because they are paranoid
Disorganized Speech
- Sometimes called "word salad" because of the way the words are arranged
- Speech may follow grammatical rules, but the content makes little sense
- Sentences make little sense, and topics of conversations change a little or not at all
Characteristic of Speech
- Such as talkative, garrulous, voluble, taciturn, unspontaneous, or normally responsive to cues from the interviewer
- Rate of speech can be normal, rapid, slow, or pressured
- Latency of speech means the patient responds spontaneously, or there are long pauses between asking a question and the patient responding
Thought Process
- General disturbance in form of thought
- Psychosis means inability to distinguish reality from fantasy
Perceptual Disturbances
- Process by which physical stimuli are brought to mental awareness
- Hallucination means false sensory perception not based on reality
- Types of hallucinations include auditory, command, visual, tactile, olfactory, and gustatory
Disturbance of Thought
- Illogical thinking means thinking that has erroneous conclusions or internal contradictions
- Autistic thinking means thinking that gratifies unfulfilled desires with no regard for reality
- Neologism means creating new words
- Word salad means incoherent mixture of words and phrases
- Circumstantiality means indirect speech that is delayed in reaching the point
- Verbigeration means meaningless repetition of specific words or phrases
- Echolalia means psychopathological repeating of words or phrases of another person
- Loose associations means ideas shift from one subject to another in an illogical manner### Thought Disorders
- Flight of Ideas: a rapid, continuous, and constant shifting of topics
- Clang Association: association of words similar in sound but not in meaning
- Incoherence: disorganized, incomprehensible thought
- Perseveration: persistent response to a prior stimulus even if the stimulus has changed
- Blocking: interruption of a train of thought before completion
Delusions
- Fixed, false beliefs based on incorrect inference about reality without factual basis
- Types of Delusions:
- Grandiose Delusions: exaggerated sense of self-importance
- Paranoid Delusions: suspicious, accusatory, or persecutory beliefs
- Somatic Delusions: beliefs about bodily changes or sensations
- Nihilistic Delusions: denial of existence of part of self
- Religious Delusions: obsessive religious beliefs
- Thought Broadcasting: believing one's thoughts are heard by others
- Thought Withdrawal: believing thoughts are removed from one's mind
- Alien Control Delusion: believing one's actions are controlled by external forces
Thought Content
- Delusions of Reference: believing events or people are related to oneself
- Obsessions: persistent, recurring thoughts or feelings
- Overvalued Ideas: believing an idea is more important than it actually is
- Persecutory Delusions: believing one is being persecuted or threatened
Speech and Language
- Latency: delay in responding to a question or prompt
- Volume: loud or soft speech
- Rate: rapid or slowed speech
- Rhythm: abnormal rhythm or cadence
- Tone: reduced or monotonous tone
- Prosody: abnormal pitch, stress, or intonation
- Perseverative Speech: repetition of words or phrases
Cognition
- Content of Thought: actual thoughts and ideas
- Affective Content: emotional tone or feeling
- Formal Thought Disorder: disorganized, circumstantial, or tangential thinking
Consciousness, Sensorium, and Cognition
- Alertness and Level of Consciousness: awareness of environment and surroundings
- Disorientation: disturbance of orientation in time, place, or person
- Clouding of Consciousness: decreased awareness and disturbance of perception and attitudes
Memory
- Remote Memory: recall of childhood events and important past events
- Recent Past Memory: recall of past few months
- Recent Memory: recall of past few days
- Immediate Retention: ability to recall information immediately
- Amnesia: partial or total inability to recall past experiences
- Paramnesia: distortion of recall
- Confabulation: filling gaps in memory with imagined or false experiences
Concentration and Attention
- Distractibility: inability to concentrate attention
- Selective Attention: ability to focus on important information and filter out irrelevant information
- Hyper vigilance: excessive attention and focus on internal and external stimuli
Capacity to Read and Write
- Ability to read and write simple sentences
- Ability to follow instructions and perform basic tasks
Visuospatial Ability
- Ability to copy a figure or design
Abstract Thinking
- Ability to deal with concepts and abstract ideas
Judgement and Insight
- Ability to assess a situation correctly and act appropriately
- Ability to understand the true cause and meaning of a situation
- Levels of Insight:
- Complete denial of illness
- Slight awareness of being sick, but denying it at the same time
- Awareness of being sick, but blaming it on others or external factors
- Awareness that illness is due to something unknown
- Intellectual Insight: admission of being sick and acknowledging failure to adapt due to irrational feelings
- Emotional Insight: awareness of being sick and willing to follow instructions or take medication
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Description
This quiz covers the basics of psychiatric assessment, including data collection, organization, and analysis, as well as the importance of establishing rapport and a good approach by the nurse.
