PSYCHIATRY: MSE| S.M.

CHOK (Manchester Medical School)

A&B
Depression

Anxiety

Mania

MOOD

THOUGHTS

appropriately
dressed/ self
neglect
stooped
posturing
reduced eye
contact
reduced
spontaneous
movement
lack of facial
expression
tearful

objective:
tearful
low mood

form:
short answer

appropriately
dressed
restlessness
agitated
irritable
?flushing, pale
mouth
sweating
fearful
avoid eye
contact

objective:
anxious
worried
?depressed

dress in bright
colours/self
neglect
restlessness
agitated
overactive

objective:
manic
"high"
elated mood

subjective:
low mood
anhedonia
poor energy

subjective:
anxious
worried
excessively
easily irritated

content:
suicidal
hopelessness
helplessness
worthlessness

form:

SPEECH

PERCEPTION

COGNITION

INSIGHT

not engaging
coherent
speech
rate
volume
monotonous

occasional
auditory
hallucination
intensity of
normal
perception

impaired
concentration
orientated in
time/ place/
person

yes
feels they need
help

normal/rate
normal volume
normal tone

no impairment

intact

yes

intact

no

content:
possible suicidal
possible self
harm
obsession

form:
grandiosity
flight of ideas
content:
self

speed
volume
increased tone
pressured
speech

delusion
grandiosity
self-worth
glory
power

PSYCHIATRY: MSE| S.M.CHOK (Manchester Medical School)

A&B

Schizophrenia
(Dx: >6/12)

Delusional
Disorder
(Dx: >1/12)

MOOD

THOUGHTS

easily distracted
disinhibited
agressive
impatient
intolerance
easily distracted

subjective:
happy
enjoying
energetic

confidence
expansive
active
optimistic
highly engaging
creative

withdrawal
suspicion
stereotypical
repetition of
purposeless
movements
mannerism
socially
awkward
?appropriately
dressed

objective:
incongruent
flattened (little
range of
expressed
emotion)
"odd"

form:
knight-move
thinking
thought echo,
blocking,
insertion,
withdrawal,
broadcasting

withdrawal
suspicion
stereotypical
repetition of
purposeless
movements
mannerism

objective:
incongruent
flattened (little
range of
expressed
emotion)
"odd"

subjective:
annoyed by
hallucination

content:
delusion
?harmful
?self-harm
(depending on
command by
voices)
form:
delusional
beliefs
content:
thoughts of
people harming
them

SPEECH

PERCEPTION

COGNITION

INSIGHT

prestige
position

negative (word
finding
problem)
circumlotory
(repetitive)
derailment (all
over the place)
perseveration
(repeat answer,
non-stop)
neogolisms
(making new
words)

delusions
(persecutory)
hallucinations

impaired
no orientated
to person/
place/ time

no

negative (word
finding
problem)
circumlotory
(repetitive)
derailment (all
over the place)

delusions
(persecutory)
hallucination
consistent with
delusion (NO
auditory/visual)

intact

no

PSYCHIATRY: MSE| S.M.CHOK (Manchester Medical School)

Dementia

Eating
Disorder

A&B

MOOD

THOUGHTS

SPEECH

PERCEPTION

COGNITION

INSIGHT

socially
awkward
?appropriately
dressed

subjective:
?frightened
?fearful
?grandiose
consistent with
the delusion

?harmful
?self-harm

perseveration
(repeat answer,
non-stop)
neogolisms
(making new
words)

neglect
amnesia
agnosia
apraxia
disinhibition
(frontotemporal)
parkinsonism

objective:
feel challenged
when
mentioned
memory prob

form:
short term
memory loss

aphasia
normal tone,
volume, speed

delusion/visual
hallucination
(lewy-body)

impaired
MMSE <25

no (some yes)
denial

underweight
normal A&B

objective:
?depressed

form:

normal tone,
speed, volume

NO delusion/
hallucination

intact

no

subjective:
self conscious

content:
feel fat

content:
normal

subjective:
?depressed
?anxious