Psychiatry MSE, DSM-5 Diagnoses, Toxicology and MORE PIES

What is the purpose of a Mental State Examination (MSE)?

A snapshot of a patient's current emotional and cognitive functioning.

What is the difference between mood and affect?

Mood is patient-reported; affect is clinician-observed.

What is the difference between an illusion and a hallucination?

Illusion misinterprets a real stimulus; hallucination occurs without an external stimulus.

What are the four PTSD symptom clusters?

Intrusion, avoidance, negative cognition/mood and altered arousal.

What is the duration of Acute Stress Disorder (ASD)?

3 days to 1 month after qualifying trauma; at least 9 symptoms.

What distinguishes Adjustment Disorder?

Emotional or behavioural symptoms after an identifiable stressor, within 3 months.

What is the DSM-5 threshold for Major Depressive Disorder (MDD)?

At least 5 symptoms over 2 weeks, including depressed mood or anhedonia.

What is the duration difference between mania and hypomania?

Mania: at least 1 week. Hypomania: at least 4 consecutive days.

What are positive symptoms of psychosis?

Additions: hallucinations, delusions and abnormal behaviour.

What are negative symptoms of psychosis?

Reductions: speech, motivation, emotional expression and social engagement.

What causes hyperventilation-related respiratory alkalosis?

Excess breathing lowers CO₂, causing respiratory alkalosis.

What is the classic opioid overdose triad?

Respiratory depression, pinpoint pupils and reduced consciousness.

What medication reverses opioid respiratory depression?

Naloxone, an opioid receptor antagonist.

What are common signs of alcohol withdrawal?

Tremors, sweating, anxiety, seizures and delirium tremens.

What are key signs of serotonin syndrome?

Clonus, hyperreflexia, agitation, sweating and hyperthermia.

What ECG change is characteristic of TCA toxicity?

Widened QRS from cardiac sodium-channel blockade.

What are key signs of lithium toxicity?

GI upset, coarse tremor, ataxia, confusion and possible seizures.

What are the four main antipsychotic extrapyramidal side effects (EPS)?

Acute dystonia, akathisia, drug-induced parkinsonism and tardive dyskinesia.

What is the treatment for acute dystonia?

Benzatropine; assess urgently for airway involvement.

What does MORE PIES stand for?

Minimal Encouragers, Open questions, Reflecting, Emotional labelling, Paraphrasing, I Messages, Effective Pauses, Summary.