Final section of the mental status examination training.
Produced and narrated by Tom Field.
Focus: Understanding psychosis and its components, including delusions and hallucinations.
Training method: Scaffolding process, ending with a comprehensive test.
Guided Practice
Review of different aspects of mental status:
Affect and Mood
Thought Process
Memory
Motor Speech
Interpersonal and Intrapersonal issues
Use of guided practice video case studies.
Definition of Psychosis
Psychosis: Idiosyncratic beliefs and perceptual experiences outside realistic possibilities, including delusions and hallucinations.
Delusion: Fixed, odd beliefs outside realistic possibilities often associated with schizophrenia.
Hallucination: Sensory perceptions not experienced by others; associated with schizophrenia, bipolar disorder, depression, delirium, and substance abuse.
Types of Hallucinations
Hypnogogic: Occur when falling asleep.
Hypnopompic: Occur when waking up.
Five sensory types:
Auditory: Hearing voices.
Visual: Seeing images.
Olfactory: Smelling odors like burnt toast.
Gustatory: Tasting unusual flavors.
Tactile: Feeling sensations like spiders crawling on skin.
Types of Delusions
Bizarre Delusions: Odd beliefs like being half human, half donut.
Control Delusions: Belief of external control over one's thoughts or actions, e.g., aliens controlling thoughts.
Grandeur Delusions: Elevated sense of importance or power, e.g., belief of winning a Nobel Prize.
Infidelity Delusions: Belief that one's partner is unfaithful without evidence.
Persecution Delusions: Belief of being harassed, e.g., FBI monitoring.
Reference Delusions: Belief that unrelated events have personal significance, e.g., news messages.
Erotomanic Delusions: Belief that another is in love with the individual without reciprocation.
Assessing Psychosis
Importance of verbal disclosure in identifying hallucinations.
Genuine hallucinations are often frightening.
Pseudo-hallucinations linked to malingering and personality disorders.
Olfactory and gustatory hallucinations can signal strokes or tumors.
Appearance in Mental Status Examination
Two facets: Grooming and dress.
Grooming: Ranges from unkempt to immaculate.
Dress: Ranges from underdressed to overdressed.
Significance of appearance usually when unkempt or disheveled.
Video Case Studies
Case studies illustrating various delusions and hallucinations.
Assessment criteria for psychosis include affect, mood, thought process, memory, and appearance.
Conclusion
Understanding psychosis requires careful observation and direct questioning.
Comprehension of delusions and hallucinations is essential for mental status examination.
Final practice involves coding for various mental status examination components.