Describe the Multiaxial Diagnosis System
"Axis I: Psych diagnosis
Axis 2: Personality and mental disorders
Axis 3: Medical dx (current e.g. HTN, diabetes)
Axis 4: Life stressors
Axis 5: Global assessment of functioning (1-90)"
Define the mental status exam process
Description of patient behavior, thoughts, perceptions, function. And objective evaluation used for dx, assessment, and response. Components are: Appearance/attitude, activity, speech, mood/affect, though/perceptual disturbances,
Define the mental status exam components: Appearance and attitude.
overall dress, cleanliness, facial expressions, hostility, withdrawn, etc.
Abnormal speech: circumstantial speech
lacks direction because of unnecessary information, but pt eventually makes his point
Define the mental status exam components: Mood/affect
"affect: prevailing emotional tone (flat, labile, blunted)
mood: describes more sustained feelings"
Thought and perceptual disturbances: delusions
Fixed false beliefs (not reality, religion, or culture). Can be paranoid, somatic, or grandiose. Pt may believe they are controlled by an outside source.
Thought and perceptual disturbances: obsessions
unwanted thoughts, ideas, impulses that intrude into pt's thinking. Pt is aware they are not normal.
Thought and perceptual disturbances: compulsions
actions performed in response to obsessions or to control anxiety with obsessions
Thought and perceptual disturbances: hallucinations
false sensory impressions with no external stimuli.
Thought and perceptual disturbances: illusions
visual perceptions that are misinterpreted, but have real sensory stimulus
Define the mental status exam components: Neuropsych eval
attention, concentration, memory, and higher cognitive functions (orientation, abstraction, calculation)
Define the mental status exam components: Insight/judgment
"insight: pt's awareness of their mental illness
judgment: ability to make appropriate decisions
Example: thinks nothing is wrong with him so doesn't take meds."
Thought and perceptual disturbances: med hx
psych and non-psych, sig, determine adequate trial, non-compliance
Thought and perceptual disturbances: medical assessment
medical-psych can cross over, med conditions can cause psych symptoms
Recall significant personality disorder components and possible treatments and consequences
Pts don't know they have a disorder.