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Psychiatric Assessment >> Mental Status Exam (MSE) (continued 2)

imageClinical Pearl

There is poor correlation between clinical impression of suicide risk and frequency of attempts.

Thought Content

  • suicidal ideation/homicidal ideation
    • low - fleeting thoughts, no formulated plan, no intent
    • intermediate - more frequent ideation, well formulated plan, no active intent
    • high -  persistent ideation and profound hopelessness/anger, well formulated plan and active intent, believes suicide/homicide is the only helpful option available
  • obsession - recurrent and persistent thought, impulse or image which is intrusive or inappropriate
    • cannot be stopped by logic or reason
    • causes marked anxiety and distress
    • common themes: contamination, orderliness, sexual, pathological doubt/worry/guilt
  • pre-occupations, ruminations (reflections/thoughts at length)
  • overvalued ideas- unusual/odd beliefs that are not of delusional proportions
  • magical thinking- belief that thinking something will make it happen; normal in kids
  • ideas of reference- similar to delusion of reference but the reality of the belief is questioned
  • delusion - a fixed false belief that is out of keeping with a person,s cultural or religious background and is firmly held despite incontrovertible proof to the contrary
  • thought insertion/withdrawal/broadcasting; delusions of control -belief that one,s thoughts/actions are controlled by some external source


Clinical Pearl : Delusions

    1. Persecutory - belief that others are trying to cause harm
    2. Delusions of reference - interpreting publicly known events/celebrities as having direct reference to the patient
    3. Erotomania - belief that another is in love with you
    4. Grandiose - belief of an inflated sense of self-worth or power
    5. Religious - belief of receiving instructions/powers from a higher being; of being a higher being
    6. Somatic - belief that one has a physical disorder/defect
    7. Nihilistic - belief that things do not exist;a sense that everything is unreal


Psychiatric Assessment >> History

Psychiatric Assessment >> Mental Status Exam (MSE)

Psychiatric Assessment >> Mental Status Exam (MSE) (continued 2)
Psychiatric Assessment >> Mental Status Exam (MSE) (continued 3)
Psychiatric Assessment >> Mental Status Exam (MSE) (continued 2) Psychiatric Assessment >> Mental Status Exam (MSE) (continued 2) Reviewed by Radiology Madeeasy on April 09, 2011 Rating: 5
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