Professional Documents
Culture Documents
General Description
1)Appearance
- overall physical impression conveyed to the therapist
- posture, poise, clothing, grooming, nails, hair, signs of
anxiety, signs of depression, chronological age
General Description con’t
2) Overt Behavior and Psychomotor Activity
- quantitative and qualitative aspect of patient’s motor
behavior
- mannerisms, gestures, twitches, hyperactive, agitation,
convulsiveness, rigidity, psychomotor retardation
MOOD
Dysphoria – unpleasant
Euthemia – normal range
Expansive – expression of feelings with ought restraint
MOOD con’t
Anxiety – apprehension
Free floating anxiety – pervasive unfocused fear not
attached to any idea
Fear – anxiety cause by unrecognized danger
Agitation – motor restlessness
Tension – unpleasant increase in motor and psychological
activity
Panic – acute episode attack of anxiety with autonomic
discharge
Apathy – dulled emotional tone
Ambivalence – 2 opposing impulses toward the same
thing, person and individual
Irritable – easily annoyed/ provoked
MOOD con’t
Mood Swings – consolation between depressive and
euphoria
Elevated – air of confidence and improvement
Euphoria – intenseclation
Fostacy – intense rapture
Depression – psychopathological sadness
Anhedonia – loss of interest in and withdrawal from
regular activities
Grief or Mourning – sadness appropriate to real loss
Aloxithemia – inability or difficulty in describing or being
aware of one’s moods
Shame – failure to live up to self expectation
Guilt – emotion secondary to doing what is committed as
wrong
AFFECT
Affect – present emotional responsiveness inferred from facial
expression and range of expressive behavior; observed
expression of behavior
Perception
Hallucination – false sensory perception not associated
with real external stimuli ( auditory, visual, olfactory, tactile)
Depersonalization
Derealization
Illusion
General Disturbances in Thought Content and Process
Psychosis – inability to distinguish reality from fantasy, impaired reality
testing
Visuospalial Ability
Memory Tests
Remote – childhood data, events prior to illness
Recent Past – past few months
Recent – few days, yesterday, a day before
Immediate – repeat six figures after examiner dictates them,
repeat three words immediately and 3.5 minutes later
Level of Insight
Complete Denial
Slight awareness of illness, needing help but denying it
Aware of illness, blaming it on others
Aware that illness is due to something unknown in the patient
Intellectual Insight
Through Emotional Insight
Impulsivity
Capacity to control sexual aggressiveness and other impulses
Ascertain patient’s awareness of sexually appropriate behavior
Measure of patient’s potential danger to himself and to others
Judgment and Insight
Capacity for sexual judgment
Establishing Rapport
1) Ease
2) Ears to listen
3) Empathy
4) Expertise
5) Evaluate insight and be ally
6) Establish authority
Beginning the Interview
Know and use patient’s name
Introduce your name
Ascertain company
Appropriate opening remarks
Be interested, ally anxiety, encourage disclosure
Maintain privacy, minimize interruption
Why now?
Interview Proper
Detailed history and Anamnesis
Systematic to identify relevant problems
Open ended questions
Psychiatric Interview
Time management
- 30 – 60 minutes
- seating arrangement
Chief Complaint
Written in patient’s own words
Reason for seeking help
Recorded even if he is unable to speak
Patient’s explanation verbatum
History of Present Illness
Comprehensive and chronological picture of events leading
up to the current moment
Summary of evolution of symptoms
Precipitation of events
Level of functioning
Appropriate information
Assure confidentiality
Therapeutic Results:
1) Gain new information or learning
2) Gain inspiration or hope
3) Interacting with others
4) Feeling of acceptance and belonging
5) Becoming aware that from now on his is not alone and that
others share the same problem
6) Gaining insight into one’s problem
7) Giving of oneself for the benefit of others
Forms of Group Therapy
1)Psychotherapy Group
Symptoms:
a) The affected person may laughh, shout, wait, bang
his head on a wall or be apathetic and withdrawn.
SIDE EFFECTS:
1) Extrapyramidal Side Effects(EPS) – are reversible
movement disorders induced by neuroleptic medications.
They include dystonic reactions, parkinsonism and
akathisia.
2) Akathisia – intense need to move about characterized
by restless movement, pacing, inability to remain still,
and the clients report for restlessness result when it is
started or increased.
** Beta-Blockers (Propanolol) is most effective in treating
Akathisia.
3) Dystonic Reaction – appears early in the course of
treatment characterized be spasm in discrete muscle
groups such as the neck muscle group (Terticollis) or eye
muscles (Coculogyric Crisis)
4) Pseudoparkinsonism or Neuroleptic – Induced
Parkinsonism – includes a shuffling gait, mask- like
faces, muscle stiffness (continuous) or cog wheeling
rigidity(rachet-like movements of pants, drooling or
akinesia (slowness and difficulty and irritating
movements)
5) Tardive Dyskinesia – late appearing side effect is
characterized by abnormal involuntary movements
such as Lip-Smucking, Tongue Protrusion, chewing,
blinking, grimacing and choreiform movement of the
limbs.
Clozapine (Closaril) – is often recommended for
clients who have experienced Tardive Dyskinrsia
Types of Delusions:
1) Persecutory/Paranoid Delusion – involves the clients
belief that “others” are planning or harm or spying or
ridiculing or belittling him.
2) Grandiose Delusion – characterized by client’s claim
to association with famous people or celebrities or
client’s behalf that he is famous or capable of great
feast.
Ex. Client claim to be the daughter of the President.
Ex. The client claim that the rape victim in the news was her,
and pointing a specific person to have raped her.
Sensorium and Intellectual Processes
a) Hallucination – of false sensory perception, or
perceptual experiences that do not exist in reality
Type of Hallucinations:
1) Auditory Hallucination – most common type which
involves hearing sounds, not open voices, talking to
or about the client
2) Visual – involve seeing images that do not exist at all
such as light or dead person.
3) Olfactory – involve smells or odors
4) Gustatory – involve a taste lingering in the mouth or a
sense that food tasted like something else.
5) Cenesthetic – involves the client’s report that he feels
bodily functions that are usually undetectable.
Ex. Sensation of impulses being transmitted through the
brain
6) Kinesthetic – occur when the client is motionless but
reports the sensation of bodily movement such as floating
above the ground