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Mental State Examination And Interventions

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Question:

Identify and Record relevant Symptoms that Gavin displayed during the Interview, and or from the Collateral obtained from his friends and find Evidenced based Nursing Mental Health Interventions to assist you in Completing the Management Plan for him.
 
 

Answer:

Metal state Examination form:

 

General appearance

 

 

 

 

Gavin is a young student in his early 20s who has been experiencing excessive drinking and was experiencing bouts of confusion and hallucinations. His general appearance is confused and agitated and he seems to be in a state of confused agitation at all times. He is not taking care of his hygiene properly and appears to be wearing dirty clothes. His clothes are minimal and are not appropriate for the weather however his built is normal. His height is close to 6 feet and his complexion is fair. His hair colour is brownish and he has piercings in his ears.

 

Behaviour

 

 

 

 

 

His behavioural characteristics exhibit signs of extreme anxiety and paranoia. He is easily agitated and provoked by the simplest of things and is exhibiting dynamic anger management problem as well (Velasquez et al., 2015). His posture remained straight throughout the interview but he could not maintain eye contact for long. His attitude towards the interviewer remained rude and irritated. Throughout the interview the patient showed signs of agitation and was easily angered. Moreover Gavin remained fidgety and restless all throughout the interview and kept repeating that he had no time for this interview.

 

Speech

 

 

 

 

The speech of the patient is comprehensible and not slurred or muted in a any manner. However the patient was not able to keep track of the questions asked to him and kept responding with illogical and irrelevant content to most of the questions asked by the interviewer.

 

Mood and

Affect

 

His mood seems to be angered and irritated throughout the interview, he is preoccupied with his thoughts and loses track of conversation when being spoke to. Other than that the patient seems to be in a constant state of paranoia and is speaking with incoherent and illogical content. As a result of his mood, his appearance and behaviour is anxious and his general expression turned anxious and depressed. There is congruency between his mood and the effect of it on his behaviour (Lewis, Dana & Blevins, 2014).

 

Thought process

 

 

 

 

 

His thought processes are fragmented and are irrelevant and bore no links to the outside world. There is lack of circumstantiality in his thought process and his responses are derailed mostly. He is exhibiting signs of flight of ideas and he has loose association between his thoughts and the questions asked to him (Jordaan & Emsley, 2014).

 

Thought content

 

 

 

His thoughts are disorganized and random with no links to the real scenarios of outside world. His thought content and the pattern were not clear and were not well connected to the reality. Moreover he was preoccupied with thoughts that spewed from his illogical and abnormal beliefs. However he did not have suicidal thoughts or morbid thoughts and was not dealing with lack of self worth.

Perception

 

 

 

 

The perception of Gavin seems to be very unclear and incoherent. He has been drinking and using illegal substances and that has affected his mental sanity. He cannot comprehend simple questions being asked to him and replies in a very different and disconnected context. Neither can he pay attention to anything around him and is having mild visual hallucination.

Cognition

 

 

 

 

His cognitive abilities seem to be impaired and are in constant state of illusion and confusion. He seems to not to be able to keep track of time, date and conversations and is unable to keep his hygiene as well. He did not appear capable recalling past activities regardless o being short term or long term.

Judgment and Insight

 

 

 

 

The judgemental capabilities of the patient is not up to par, he cannot process his surroundings properly and makes up imaginative scenarios in his head. He cannot evaluate choices and arrive at appropriate conclusion or take adequate decision.

Neurovegetative

 

 

 

The neurovegetative symptoms that he had been exhibiting are:

  • Anxiety
  • Confusion
  • illusions
  • Agitation
  • Mood swings
  • Lack of sleep, early signs of insomnia
  • Loss of appetite (Hamburger, 2016)

 

 

 

 

 

Mark for MSE   /  Comments                                                               /10

 

Symptoms and interventions :

Sympton

1mark for each appropriate symptom

                                                     Interventions

1 mark for the symptoms and 0.75 mark for each intervention and 0.25 for intext reference

 

Gavin has been displaying symptoms of agitation 

 

  • The patient should be made comfortable in his environment so that he can relax (Connors et al., 2012).
  • The patient should also be encouraged to try meditation to calm his agitation.
  • As pharmacological intervention, the patient should be administered antipsychotics like haldol (Butcher, Hooley & Mineka, 2015).

 

Gavin is exhibiting symptoms of paranoia

 

 

  • The major interventions that Gavin should immediately be on are psycho counselling that can help Gavin get back his bearings (Butcher, Hooley & Mineka, 2015).
  • The counsellor should establish a mutually respectful relationship with Gavin so that he trusts the counsellor enough to share his problems and grievances
  • Antipsychotics can also be administered which can seriously diminish the intensity of the symptoms (Bouzyk-Szutkiewicz, Waszkiewicz & Szulc, 2012).

Gavin is displaying the symptoms of illusion and personality disorder .

  • The intervention that can reduce the illusions and personality disorders can be extensive cognitive behavioural therapy coupled with heavy antipsychotics.
  • The antipsychotics will pharmacologically target the brain functions to reduce the intensity of the immense personality disorders he is experiencing (Lewis, Dana & Blevins, 2014).
  • The counselling therapy can psychologically help him deal with his substance abuse and overcome his illusions.
  • A group counselling therapy can help him overcome his apprehension and fear and will aid his cognitive heath by interacting with others dealing with similar problems and will motivate him to try to fight this mental disorder and attain recovery (Hamburger, 2016).

 

 Mark for Symptoms and Interventions / Comments.                      

 

 

 

References:

Bouzyk-Szutkiewicz, J., Waszkiewicz, N., & Szulc, A. (2012). Alcohol and psychiatric disorders. Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego, 33(195), 176-181.

Butcher, J. N., Hooley, J. M., & Mineka, S. M. (2015). Abnormal psychology. Pearson Higher Ed.

Connors, G. J., DiClemente, C. C., Velasquez, M. M., & Donovan, D. M. (2012). Substance abuse treatment and the stages of change: Selecting and planning interventions. Guilford Press.

Hamburger, B. (2016). Alcoholism and Paranoia—the 1970's: A Decade of Transition. Psyccritiques, 61(32).

Jordaan, G. P., & Emsley, R. (2014). Alcohol-induced psychotic disorder: a review. Metabolic brain disease, 29(2), 231-243.

Lewis, J. A., Dana, R. Q., & Blevins, G. A. (2014). Substance abuse counseling. Cengage Learning.

Miku?a, J., Szelenbaum, W., & Kokoszka, A. (2014). Towards a cognitive model of hallucinations in the course of alcohol dependence? A source monitoring-based pilot study. Psychological medicine, 44(13), 2763-2773.

Velasquez, M. M., Crouch, C., Stephens, N. S., & DiClemente, C. C. (2015).Group treatment for substance abuse: A stages-of-change therapy manu
OR

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