NR 547 Week 1
• MSE: thought process: normal: Linear, organized, goal directed
• MSE: thought process: flight of ideas: Rapid movement from one thoughtto another, a
succession of multiple associations, so that thoughts seem to moveabruptly from idea to idea,
expressed through rapid pressured speech
• clang associations: Thoughts are associated by the sound of words, ratherthan by their
meaning, rhyming, or assonance
• derailment: A breakdown in both the logical connection between ideas, and theoverall
sense of goal directedNess
• MSE: thought process: circumstantial: Over inclusion of details and materialthat is not
directly relevant to the subject or an answer to the question, but does eventually return to
address the subject or answer the question
• MSE thought process: tangential: Patient does a reply that is appropriate to the general
topic without actually answering the question... Have you had any troublesleeping lately... I
usually sleep in my bed, but now I'm on the sofa
• MSE thought process: Loose thoughts: Thoughts that are difficult or impos-sible to see
the connections between the sequential Contant
• MSE thought process: perseveration: Tendency to focus on a specific idea orcontact
without the ability to move on to other topics. Repetition of out of context, words, phrases, or
ideas.
• MSE thought process: blocking: Disordered thought process in which patientappears to be
unable to complete a thought- stops midsentence and then cannot remember what was being
discussed
• MSE thought process: neologisms: That process, whereby patient refers to anew word or
condensed combination of several words that is not a true word, and not readily
understandable... Ginormous,
• MSE thought process: word salad: Speech characterized by confused andoften repetitious
language with no apparent meaning, or relationship attached
• MSE: Perceptual Disturbances: hallucinations, illusions, derealization, deper-sonalization
• Perceptual disturbances: hallucinations: Perceptions in the absence of stim-uli to account
for them; auditory, visual, tactile, olfactory, and gustatory
• non-auditory hallucinations: Neurological, medical, or substance withdrawalissue
• visual hallucinations originate in the lobe: temporal or occipital-most
, common form of hallucinations in schizophrenia
• illusion: (n.) a false idea; something that one seems to see or to be aware thatreally does
not exist. Water in the desert, wind rustling is people talking
• Depersonalization: feelings of detachment from one's mental processes orbody
• Derealization: the sense that one's surroundings are unreal or detached
• MSE: Cognition: Alertness, orientation, concentration, memory, calculation, fund of
knowledge, abstract, reasoning, insight, judgment. Intelligence versus cog-nitive impairment
versus delirium versus dementia.
• MSE - alertness and orientation: Observation and person place time context
• MSE: Concentration: Serial sevens, letters of the alphabet backward, monthsof the year
backward
• MSE: Memory: immediate-number repeat,
recent- what did you have for breakfast? Remember three words
remote-address when you were in third grade summer between high school andcollege
• MSE calculation: Simple and complex math calculations
• MSE fund of knowledge: Distance between New York and Los Angeles, bodyof water
between South America and Africa
• MSE: Abstract Reasoning: Which one of these does not belong? How are these related?-
Ability to shift back-and-forth between general and specific concepts.
• MSE: Insight: Clients understanding of own feelings, presenting, and function-ing, as
well as potential causes of psychiatric presentation
• MSE: Judgement: ability to make sound and reasonable decisions
e.g. what would you do if you smelt a fire on your street?
- evaluate recent situations (e.g. answers questions correctly but wears a jacket in30 degrees)
• Physical Eval AIMS: Abnormal involuntary movement scale end used to moni-tor for
potential side effects of tardive dyskinesia with antipsychotic use
• psych interview: Identifying dataChief complaint
HPI
Previous psychiatric mental disordersPersonal and social history Childhood
Adolescence Adulthood Sexual historyFamily history
Mental status exam
• childhood trauma: Separation anxiety and school phobia are associated withadult,
• MSE: thought process: normal: Linear, organized, goal directed
• MSE: thought process: flight of ideas: Rapid movement from one thoughtto another, a
succession of multiple associations, so that thoughts seem to moveabruptly from idea to idea,
expressed through rapid pressured speech
• clang associations: Thoughts are associated by the sound of words, ratherthan by their
meaning, rhyming, or assonance
• derailment: A breakdown in both the logical connection between ideas, and theoverall
sense of goal directedNess
• MSE: thought process: circumstantial: Over inclusion of details and materialthat is not
directly relevant to the subject or an answer to the question, but does eventually return to
address the subject or answer the question
• MSE thought process: tangential: Patient does a reply that is appropriate to the general
topic without actually answering the question... Have you had any troublesleeping lately... I
usually sleep in my bed, but now I'm on the sofa
• MSE thought process: Loose thoughts: Thoughts that are difficult or impos-sible to see
the connections between the sequential Contant
• MSE thought process: perseveration: Tendency to focus on a specific idea orcontact
without the ability to move on to other topics. Repetition of out of context, words, phrases, or
ideas.
• MSE thought process: blocking: Disordered thought process in which patientappears to be
unable to complete a thought- stops midsentence and then cannot remember what was being
discussed
• MSE thought process: neologisms: That process, whereby patient refers to anew word or
condensed combination of several words that is not a true word, and not readily
understandable... Ginormous,
• MSE thought process: word salad: Speech characterized by confused andoften repetitious
language with no apparent meaning, or relationship attached
• MSE: Perceptual Disturbances: hallucinations, illusions, derealization, deper-sonalization
• Perceptual disturbances: hallucinations: Perceptions in the absence of stim-uli to account
for them; auditory, visual, tactile, olfactory, and gustatory
• non-auditory hallucinations: Neurological, medical, or substance withdrawalissue
• visual hallucinations originate in the lobe: temporal or occipital-most
, common form of hallucinations in schizophrenia
• illusion: (n.) a false idea; something that one seems to see or to be aware thatreally does
not exist. Water in the desert, wind rustling is people talking
• Depersonalization: feelings of detachment from one's mental processes orbody
• Derealization: the sense that one's surroundings are unreal or detached
• MSE: Cognition: Alertness, orientation, concentration, memory, calculation, fund of
knowledge, abstract, reasoning, insight, judgment. Intelligence versus cog-nitive impairment
versus delirium versus dementia.
• MSE - alertness and orientation: Observation and person place time context
• MSE: Concentration: Serial sevens, letters of the alphabet backward, monthsof the year
backward
• MSE: Memory: immediate-number repeat,
recent- what did you have for breakfast? Remember three words
remote-address when you were in third grade summer between high school andcollege
• MSE calculation: Simple and complex math calculations
• MSE fund of knowledge: Distance between New York and Los Angeles, bodyof water
between South America and Africa
• MSE: Abstract Reasoning: Which one of these does not belong? How are these related?-
Ability to shift back-and-forth between general and specific concepts.
• MSE: Insight: Clients understanding of own feelings, presenting, and function-ing, as
well as potential causes of psychiatric presentation
• MSE: Judgement: ability to make sound and reasonable decisions
e.g. what would you do if you smelt a fire on your street?
- evaluate recent situations (e.g. answers questions correctly but wears a jacket in30 degrees)
• Physical Eval AIMS: Abnormal involuntary movement scale end used to moni-tor for
potential side effects of tardive dyskinesia with antipsychotic use
• psych interview: Identifying dataChief complaint
HPI
Previous psychiatric mental disordersPersonal and social history Childhood
Adolescence Adulthood Sexual historyFamily history
Mental status exam
• childhood trauma: Separation anxiety and school phobia are associated withadult,
