-
A & B
Appearances
- - Level of consciousness
- - General impression:
- (body built, of physical illness, posture, cleanliness, w loss, self harm)
- - Face: facial expression
- (eye contact, expression, blank & expressionless)
- - Dress
- (bizarre, dirty, revealing, inapp. for weather, extra layers, cover up)
-
A & B (2)
Behaviours
- - Motor:
- (speed, repetitive or rhythmic writhing (choreoatheosis), chewing of mouth/trembling lips in tar dive dyskinesia), abnormal movements, rituals
- - Attitude to interview
- (friendly, hostile, suspicious)
-
S
Speech
- 1. Speech form
- - Spontaneity
- - Speed
- - Volume
- - Quantity
- - Quality
- 2. Speech content
- - Neologism
- - Punning & clang associations
- - Expressive dysphasia (Broca's or non-fluent dysphasia)
- - Obscene words
- - Poor fluency
- + poor education
- + thought disorder/circumstantiality
- + receptive dysphasia (Wernicke's or fluent dysphasia)
- + echolalalia
- + perseveration
-
Thought form
- 1. Fluency
- - Circumstantiality
- - Loosening of associations
- (extreme word salad)
- 2. Flow
- - Changes: in speed, V
- - Interruptions:
- + Thought block
- + Perseveration
- - Deviations:
- + Derailment
- + Tangentiality
- + Flight of ideas
- - Funny words
-
Emotions
Affects (objectively) and Mood (subjectively)
- 1. Affects
- - Euthymic?
- - Types: adj: happy, sad, angry, detached, appropriate, congruous
- - Intensity
- - Stability:
- + in degree of intensity
- + variability of type: blunted or labile
- - Appropriateness
- - Congruity
- 2. Mood
- - Types
- + Depression
- + Hypomania
- + Anxiety
- + Irritability
- - Intensity
- - Chronicity
- - Stability ( delusional mood)
-
Perceptions
- 1. Hallucinations
- - Modalities: VAKOG
- + A: crude / complex
- second person voices, 3rd person voices, thought echo, commentary
- - Complexity:
- (crude, complex)
- - Trigger factors:
- (funtional hal, reflex, hypnogogic or hypnapompic hal)- Other perceptual abnormalities
- (illusions, pseudo-hal, depersonalisation and derealisation, Capgras syndrome, Deja vu or jamais vu)
-
Thought content
- I. Types
- - Primary delusions
- - Secondary ''
- - Systematised "
- - Mood-congruent "
- - Folie à deux
- II. Themes
- 1. Delusional content
- - Persecutory
- - Reference
- - Control/passitivity
- - Grandiose
- - Guilt
- - Worthlessness
- - Infestation - Ekbom
- - Nihilistic
- - Capgras - misidentification
- - Hypochondriacal
- 2. Non-delusional content
- - Overvalued ideas
- - Phobias
- - Obsessional symptoms
- (ruminations, ideas, memories, imagery)
- - Suicidal ideation
- - Hyponchondriasis
- - Dysmorphophobia
- - Eating disorders
-
Cognition
- * Domains x4
- - Level of consciousness
- - Orientation ( time -> date -> place -> person)
- - Attention and concentration
- - Memory: short- & long-term
- * How
- 1. informal: orientation to time, space and person
- 2. formal testing:
- - Screening
- + AMTS
- + MMSE
- - More detailed
- + ACE - Addenbrookes
- - Pyschometric testing
-
Insights
- - is the pt aware that something is wrong?
- - is the problem internal or external?
- - does the pt think it is the result of an illness?
- - is the problem physical or psychological?
- - if psy, can it be helped?
- - is the pt willing to accept help?
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