Mental state exam

Panic disorder Agoraphobia Specific phobias GAD OCD

1. Recurrent panic attacks

2. Psychological: derealisation/depersonalisation, fear of losing control, dying

3. Not secondary- no stimulus, starts randomly

4. Persistent worry about having another attack Phobic avoidance

palpitations, tremor, sweating, chest pain, nausea

1.5-3.7% prevalence

Fear of crowds Anxiety and panic symptoms associated with places or situations

Escape may be difficult/embarrassing Crowds, public places, travelling alone Avoidance

Prevalence 2.8-5.8%

30-40 year old women

• Recurrent/excessive/unreasonable symptoms of anxiety

• Autonomic

• Psychological

• Anticipated presence of specific feared object/activity Spiders, snakes, heights etc

Lifetime prevalence 12.5%

Anxious about everything. E.g. I have to do the dishes then cook etc.

Free-floating anxiety

• Excessive worry

• Generalised, free-floating, persistent anxiety

• Apprehension about everyday events/problems

• muscle and psychic tension

• Significant distress/functional impairment

• Sleeping issues

Prevalence 2.5-6.4%

Continuous thoughts that can't be forgot through ditraction.

Idea, image or impulse Recognised as own Repetitive, intrusive, distressing

Unnecessary/purposeless action Avoids occurrence of adverse event Relieves anxiety (in short term!)

Prevalence 0.5-3%

Bipolar disorder

Depressive episode Manic/hypomanic episode

• Core symptoms: depressed mood, anergia, anhedonia

• Biological symptoms: disturbed sleep, diminished appetite, reduced concentration

• Psychological symptoms: reduced self-esteem, self-confidence; ideas of guilt/unworthiness; bleak view of future; ideas/acts of self-harm/suicide

-Mild: two core plus two others, not intense, 2w -Mod: two core plus 3-4 others, marked intensity -Severe: three core plus four others; severe intensity, <2w; +/- psychosis

Lifetime prevalence 10-20%

Increased energy (overactivity, reduced sleep) Formal thought disorder (pressured speech, flight of ideas) Increased self esteem: grandiosity, disinhibition., over-familiarity Reduced attention Consequential behaviours (schemes, spending, sexual encounters) Psychotic symptoms

Abnormally and persistently elevated/expansive/irritable mood with 3+ symptoms; 1w duration; significant impairment of functioning

Three or more symptoms over at least 4d

Not severe enough to: Interfere with social/occupational functioning Require admission to hospital Include psychotic features

2+ episodes, one of which must be manic/hypomanic or mixed; complete recovery between episodes

Prevalence 1%

Mania

Hypomania

Schizophrenia Delusional disorder

At least one of: Thought echo/insertion/withdrawal/broadcast Delusions of control/passivity and delusional perception Auditory hallucinations (3rd person, running commentary Implausible delusions

Or at least two of: Persistent hallucinations with non-affective delusions Breaks in train of thought Catatonic behaviour Apathy/blunting Loss of interest/social withdrawal

For at least 1mo

15 new cases per 100 000 population

1%

Non-bizarre delusions No hallucinations/thought disorder/mood disorder/flattening of affect

1 month

Prevalence 0.025-0.03%