Mental Status Examination of an Exceptional Case of Longevity

1995 ◽  
Vol 166 (2) ◽  
pp. 229-235 ◽  
Author(s):  
Karen Ritchie
Keyword(s):  
Mental Status ◽  
Verbal Memory ◽  
Protective Factor ◽  
Depressive Symptomatology ◽  
Extreme Case ◽  
Exceptional Case ◽  
Intellectual Ability ◽  
Language Fluency ◽  
History Of ◽  
Mental Status Examination

BackgroundThe mental status examination of an extreme case of longevity, J. C., aged 118 years and 9 months, is documented in order to further knowledge regarding profiles of morbidity in the extremely elderly. J. C. is presently considered to have the longest authenticated life-span in the history of the human species.MethodNeuropsychological tests were improvised taking into account the subject's severe perceptual deficits. The examination was carried out over a six-month period. A CT scan was also conducted.ResultsThe subject's performance on tests of verbal memory and language fluency is comparable to that of persons with the same level of education in their eighties and nineties. Frontal lobe functions are relatively spared and there is no evidence of depressive symptomatology or other functional illness. Cognitive functioning was found to slightly improve over a six-month period.ConclusionsThe subject shows no evidence of progressive neurological disease. A high initial level of intellectual ability may have constituted a protective factor.

The Psychiatric Interview and Mental Status Examination

2017 ◽  
Author(s):  
Donald W. Black
Keyword(s):  
Differential Diagnosis ◽  
Social History ◽  
Mental Status ◽  
Treatment Plan ◽  
Essential Elements ◽  
Comprehensive Treatment ◽  
Psychiatric Interview ◽  
Psychomotor Activity ◽  
History Of ◽  
Mental Status Examination

The interview and mental status examination are integral to the comprehensive patient assessment and typically follow a standard approach that most medical students and residents learn. The psychiatrist should adjust his or her interview style and information-gathering approach to suit the patient and the situation. For example, inpatients are typically more symptomatic than outpatients, may be in the hospital on an involuntary basis, and may be too ill to participate in even the briefest interview. Note taking is an essential task but should not interfere with patient rapport. The interview should be organized in a systematic fashion that, although covering all essential elements, is relatively stereotyped so that it allows the psychiatrist to commit the format to memory that, once learned, can be varied. The psychiatrist should start by documenting the patient’s identifying characteristics (age, gender, marital status) and then proceed to the chief complaint, history of the present illness, past medical history, family and social history, use of drugs and alcohol, medications, and previous treatments. A formal mental status includes assessment of the patient’s appearance, attitude, and behavior; orientation and sensorium; mood and affect; psychomotor activity; thought process, speech, and thought content; memory and cognition (including attention and abstraction); and judgment and insight. With the data collected, the psychiatrist will construct an accurate history of the symptoms that will serve as the basis for developing a differential diagnosis, followed by the development of a comprehensive treatment plan. This review contains 1 figure, 3 tables, and 12 references. Key words: assessment, differential diagnosis, interviewing, mental status examination, treatment plan

Detecting a History of Incest: A Predictive Syndrome

1985 ◽  
Vol 66 (9) ◽  
pp. 525-532 ◽  
Author(s):  
Gerald S. Ellenson
Keyword(s):  
Women Survivors ◽  
Mental Status ◽  
History Of ◽  
Mental Status Examination

The author describes thought content and perceptual symptoms shared by women survivors of childhood incest. The syndrome, if confirmed, may make it possible to detect such incest, through the expanded use of a mental status examination, in one unstructured interview.

The Mental Status Examination for Dementia: A Review of Practice in a Psychiatric Hospital*

1983 ◽  
Vol 28 (4) ◽  
pp. 287-290 ◽  
Author(s):  
B.A. Martin ◽  
A.M. Peter ◽  
M.R. Eastwood
Keyword(s):  
Cognitive Function ◽  
Mental Status ◽  
Discharge Diagnosis ◽  
Hospital Discharge Diagnosis ◽  
Organic Mental Disorders ◽  
Diagnosis Of Dementia ◽  
Recent Developments ◽  
History Of ◽  
Mental Status Examination

The mental status examinations of 63 patients with a hospital discharge diagnosis of dementia were reviewed. The examination and documentation of most areas of cognitive function were found to be incomplete in the majority of cases. The need for a complete examination of cognitive function is discussed in relation to the natural history of dementia and in the context of recent developments in the classification of organic mental disorders.

The Psychiatric Interview and Mental Status Examination

2017 ◽  
Author(s):  
Donald W. Black
Keyword(s):  
Differential Diagnosis ◽  
Social History ◽  
Mental Status ◽  
Treatment Plan ◽  
Essential Elements ◽  
Comprehensive Treatment ◽  
Psychiatric Interview ◽  
Psychomotor Activity ◽  
History Of ◽  
Mental Status Examination

The interview and mental status examination are integral to the comprehensive patient assessment and typically follow a standard approach that most medical students and residents learn. The psychiatrist should adjust his or her interview style and information-gathering approach to suit the patient and the situation. For example, inpatients are typically more symptomatic than outpatients, may be in the hospital on an involuntary basis, and may be too ill to participate in even the briefest interview. Note taking is an essential task but should not interfere with patient rapport. The interview should be organized in a systematic fashion that, although covering all essential elements, is relatively stereotyped so that it allows the psychiatrist to commit the format to memory that, once learned, can be varied. The psychiatrist should start by documenting the patient’s identifying characteristics (age, gender, marital status) and then proceed to the chief complaint, history of the present illness, past medical history, family and social history, use of drugs and alcohol, medications, and previous treatments. A formal mental status includes assessment of the patient’s appearance, attitude, and behavior; orientation and sensorium; mood and affect; psychomotor activity; thought process, speech, and thought content; memory and cognition (including attention and abstraction); and judgment and insight. With the data collected, the psychiatrist will construct an accurate history of the symptoms that will serve as the basis for developing a differential diagnosis, followed by the development of a comprehensive treatment plan. This review contains 1 figure, 3 tables, and 12 references. Key words: assessment, differential diagnosis, interviewing, mental status examination, treatment plan

The Psychiatric Evaluation

2018 ◽  
pp. 359-376
Author(s):  
Carol S. North ◽  
Sean H. Yutzy
Keyword(s):  
Mental Illness ◽  
Decision Tree ◽  
Psychiatric Disorder ◽  
Mental Status ◽  
Psychiatric Evaluation ◽  
Basic Principles ◽  
Specific Advice ◽  
History Of ◽  
Mental Status Examination ◽  
And Behavior

The psychiatric evaluation is a review of the basic principles of approaching a patient with a suspected psychiatric disorder. Specific advice is advanced regarding the interview style, questioning (open-ended versus closed), focus of interview (history of illness), and demeanor (e.g., friendly, sympathetic, respectful). The details of mental status examination are then reviewed with examples provided of positive findings in each of five categories: appearance and behavior, affect and mood, form and content of thought, memory and intellectual functioning, and insight and judgment. These examples are designed to flesh out the student’s understanding of mental illness. A decision tree is provided to facilitate efficient clinical focus on the major issues. Recommendations are provided for effectively presenting a case in a formal setting.

A method for quantifying a mental status examination

2013 ◽  
Author(s):  
R. C. Spaulding ◽  
M. Richlin ◽  
J. D. Phelan
Keyword(s):  
Mental Status ◽  
Mental Status Examination

scholarly journals P.005 Lisdexamfetamine precipitated pathological gambling

2018 ◽  
Vol 45 (s2) ◽  
pp. S17-S17 ◽  
Author(s):  
F Chaudhary ◽  
A Hirsch ◽  
W MacPherson ◽  
J Nayati
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Nucleus Accumbens ◽  
Pathological Gambling ◽  
Risk Taking ◽  
Gambling Behavior ◽  
Hyperactivity Disorder ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
History Of ◽  
Mental Status Examination

Background: Lisdexamfetamine has not heretofore been reported to cause pathological gambling. Such a case is presented. Methods: A middle-aged woman, without past interest in gambling, gaming, or risk taking behavior, with childhood history of attention deficit hyperactivity disorder presented with difficulty focusing and concentrating. Lisdexamfetamine was started at 20 mg daily and gradually escalated due to lack of efficacy. At 70 mg daily, she began binging on sweets and gambling all day, every day at nearby riverboats, which she had never frequented previously. Upon reduction to 60 mg daily, the gambling resolved. Ritalin 20 mg every morning and 50 mg every afternoon was used without gambling reoccurrence. Results: Mental Status Examination: Alert, cooperative and oriented x 3 with good eye contact. Euthymic, without mania, thoughts logical and goal directed. Conclusions: Enhanced dopamine in the nucleus accumbens may induce hedonic activities including gambling, binging on sweets, or sexual activity (Moore et al. 2014). Lisdexamfetamine has been described to induce mania, and pathological gambling may have been an isolated manifestation of early mania. In those who have recently begun lisdexamfetamine, query should be made regarding change in gambling behavior and in those who are pathologically gambling, investigation should be entertained as to whether they are taking lisdexamfetamine.

scholarly journals Recurrent noncirrhotic hyperammonemia causing acute metabolic encephalopathy in a patient with a continent ileocecal pouch: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
T. M. Skipina ◽  
S. Macbeth ◽  
E. L. Cummer ◽  
O. L. Wells ◽  
S. Kalathoor
Keyword(s):  
Emergency Department ◽  
Metabolic Acidosis ◽  
Mental Status ◽  
Rare Case ◽  
Liver Function Tests ◽  
Altered Mental Status ◽  
Potassium Citrate ◽  
Metabolic Encephalopathy ◽  
History Of ◽  
Normal Urine

Abstract Introduction Acute encephalopathy, while a common presentation in the emergency department, is typically caused by a variety of metabolic, vascular, infectious, structural, or psychiatric etiologies. Among metabolic causes, hyperammonemia is relatively common and typically occurs in the setting of cirrhosis or liver dysfunction. However, noncirrhotic hyperammonemia is a rare occurrence and poses unique challenges for clinicians. Case presentation Here we report a rare case of a 50-year-old Caucasian female with history of bladder cancer status post chemotherapy, radical cystectomy, and ileocecal diversion who presented to the emergency department with severe altered mental status, combativeness, and a 3-day history of decreased urine output. Her laboratory tests were notable for hyperammonemia up to 289 μmol/L, hypokalemia, and hyperchloremic nonanion gap metabolic acidosis; her liver function tests were normal. Urine cultures were positive for Enterococcus faecium. Computed tomography imaging showed an intact ileoceal urinary diversion with chronic ileolithiasis. Upon administration of appropriate antibiotics, lactulose, and potassium citrate, she experienced rapid resolution of her encephalopathy and a significant reduction in hyperammonemia. Her hyperchloremic metabolic acidosis persisted, but her hypokalemia had resolved. Conclusion This case is an example of one of the unique consequences of urinary diversions. Urothelial tissue is typically impermeable to urinary solutes. However, when bowel segments are used, abnormal absorption of solutes occurs, including exchange of urinary chloride for serum bicarbonate, leading to a persistent hyperchloremic nonanion gap metabolic acidosis. In addition, overproduction of ammonia from urea-producing organisms can lead to abnormal absorption into the blood and subsequent oversaturation of hepatic metabolic capacity with consequent hyperammonemic encephalopathy. Although this is a rare case, prompt identification and treatment of these metabolic abnormalities is critical to prevent severe central nervous system complications such as altered mental status, coma, and even death in patients with urinary diversions.

Managing the Health of Chosŏn Kings: Illness and Treatment in the Daily Records of the Royal Secretariat

2016 ◽  
Vol 11 (1-2) ◽  
pp. 171-191 ◽  
Author(s):  
Wung Seok Cha
Keyword(s):  
Social History ◽  
Mental Status ◽  
Daily Activities ◽  
The Political ◽  
Korean Language ◽  
Historical Source ◽  
Choson Dynasty ◽  
The Social ◽  
History Of ◽  
Shed Light

TheSŭngjŏngwŏn ilgi (Daily Records of the Royal Secretariat)is one of the major chronicles of the events of the Chosŏn Dynasty (1392–1910). Although the records prior to the year 1622 are no longer extant, the remaining records from the years 1623 to 1910 meticulously recount the daily activities of the reigning Chosŏn kings, including copious information on their physical and mental status. Because the king’s health was considered as important as other official affairs in many respects, detailed records were kept of royal ailments and how court doctors treated them. This article surveys the state of Korean-language scholarship on the medical content of theDaily Recordsand presents selected translations to demonstrate how this valuable historical source can shed light on both the social history of Chosŏn medicine and the political importance of kingly health at the Chosŏn court.

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