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govind

mania -assess

6 posts in this topic

kindly pardon me if this has been discussed before, any ideas how to approach this station which came up on last day in Spring CASC .was the task more related to history taking or to do a mental stae examination?many thanks

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sorry , I remember vaguely -assess this person whom GP has referred to you turns up 5 hours late , has been on antidepressants in the past, GP is concerned about him ,on examining him he was manic with flight of ideas, using first name throughout , overactive

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This was one station where I scored A. I allowed this person to speak for about one minute and then interrupted by saying, I know these topics are important but do you mind if I interrupt to ask some more important issues. He kept talking and talking but gave clear symptomatology such as his busy work schedule, unable to keep focus on any particular topic, grandiosity even some psychotic symptoms and I kept pointing this to the examiner. The only problem with station was abrupt ending at the end of 7 minute.

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This was one station where I scored A. I allowed this person to speak for about one minute and then interrupted by saying, I know these topics are important but do you mind if I interrupt to ask some more important issues. He kept talking and talking but gave clear symptomatology such as his busy work schedule, unable to keep focus on any particular topic, grandiosity even some psychotic symptoms and I kept pointing this to the examiner. The only problem with station was abrupt ending at the end of 7 minute.

So the structure of that would be:

Go along with the patient

Interrupt appropriately

Follow cues

History of Present Illness and Mental State:

Biological Symptoms:

Summarise or recap if you can

Sleep - insomnia

Appetite - increased or decreased

High energy

Increased libido (How to ask?) Do you notice any change in your sexual dsire?

Psychological

Increased plans

Cheerfulness

Grandiosity re. abilities and identity

Flight of ideas: It seems that you have a lot of thoughts in your mind ; do you notice as if thoughts are racing inside your mind?

Social

Overtalkativeness

Overactivity

Overfamiliarity

Overspending

Psychotic Symptoms

Grandiose delusions

Persecutory delusions

First rank symptoms : Thought insertion, Thought withdrawal and broadcast

Auditory Hallucinations including command ones

Risk Issues

Lability of mood and getting transient suicidal thoughts

Acting on command hallucinations

Acting according to grandiose delusions

Exploitation by others

Overspending and bankrupcy

Past Psychiatric History

What antidepressant he was on? When started taking? Any prior admissions? Felt as happy in the past as feeling now?

Substance Misuse

Any alcohol/substance misuse as a cause or consequence of mania

Social History

Impact of above symptoms on his social life. Able to work or doesn't bother? Doesn't feel the need to work now as he has a lot of money already? etc.

Family history if time allows

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thanks mental and afterlife,this is quite helpful any more suggestions?

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