Case Study: Annabelle's Mental Health

This assignment presents a case study of a patient named Annabelle who exhibits various mental health symptoms. The task requires students to analyze her symptoms, such as choreiform movements, akathisia, and pseudohallucinations, and formulate potential diagnoses. Additionally, students must consider the potential side effects of antipsychotic medication on Annabelle's condition and discuss relevant clinical observations.

MENTAL HEALTH

TABLE OF CONTENTS
QUESTION 1......................................................................................................................................3
Thought form and thought content and state how they are related to Mental State Exam and
discuss how Annabelle’s thoughts are disturbed.........................................................................3
QUESTION 2......................................................................................................................................3
Define perception as it relates to a MSE and then discuss how we might interpret how
Annabelle may have some disturbance in one or more of her senses.........................................3
QUESTION 3......................................................................................................................................4
Define both ‘affect’ and ‘mood’. How would you describe Annabelle’s mood and the range
and intensity of her affect............................................................................................................4
QUESTION 4......................................................................................................................................5
Giving examples from the Case Study, how would you describe her behaviour and her
appearance as set out in a MSE?..................................................................................................5
REFERENCES.....................................................................................................................................7

QUESTION 1
Thought form and thought content and state how they are related to Mental State Exam and
discuss how Annabelle’s thoughts are disturbed
Thought form refers to the tempo of thoughts wherein some people experience flights of
ideas and thoughts usually move so rapidly that further makes the speech incoherent. The form
of thought indicate the specific problems which also includes several types of thought disorder
such as neologisms and derailment and that often changes the behaviour and attitude of a person
(Nolan and et.al., 2016). There are several elements included in the thought form wherein
individual may be described as having retarded or inhibited thinking. This changes behaviour of
a person and may also get affected due to pattern of interruptions and disorganization of thought
processes (ander, Lempinen, Ristkari and Klomek, 2016).
Thought content describes a patient’s delusions, obsessions, phobias and preoccupations.
Under this concept, thoughts keeps on changing and multiple thoughts come at a time in the
mind. It also changes the degree of belief that is associated with the thoughts. Suicidal, homicidal
ideas and feeling of obsession also considered in the thought content (Koslowski and et.al.,
2016). Both the concepts are related to Mental State Exam which aids to find out comprehensive
cross- sectional description of patient’s mental state. In the present case, Annabelle is
experiencing flights of ideas wherein she gets frequent changes in her speech and as a result, this
makes her speech incoherent.
Although the registered nurse, have carefully observed a distinguish chain of poetic
associations in the patient’s speech (Poppen and et.al., 2016). Thus, it can be said that she has
few associations in her mind which makes her scream when she sees the ceiling. In every
situation, a number of things come in her mind which ultimately changes her behaviour. In this
situation, registered nurses could have performed Mental State Examination which could reveal
cognitive impairment about patient (Annabelle).

QUESTION 2
Define perception as it relates to a MSE and then discuss how we might interpret how Annabelle
may have some disturbance in one or more of her senses
Perception is sensory experience and the three broad categories of perceptual disturbance
are hallucinations, pseudohallucinations and illusions (Coyne, McDaniel and Stockdale, 2016).
Hallucinations is defined as a sensory perception where external stimuli does not exist and it is
experienced in external space. On the other hand, illusion is defined as a false sensory perception
which exists in the presence of external stimulus and it could also be recognised as a distortion of
a sensory experience (Dawes and et.al., 2016). Other dimension is pseudohallucinations which is
experienced in internal or subjective space. In this sensation, patient makes numerous fantasies
which changes his or her viewing acts.
In the present case, Annabelle is having pseudohallucinations perception which led her to
think too much regardless of the thoughts that come in her mind (Ettner, 2016). This can be
justified through considering her condition especially when she screams “they are everywhere,
they are under my skin and the whole planet is falling”. She then turns to be distressed and as a
result she proceeds back to screaming. Even if nothing is there near to her; still she keeps on
screaming as if something is there in front of her (Koslowski and et.al., 2016).
She always looks up to the celling and she stares like something is there; this amends her
thought process. In terms of perception, it can be said that she has other sensory abnormalities as
well which includes a distortion of the patient’s sense of time. Patient also loses the sense of self
depersonalization and sense of reality (Belsher and et.al., 2016). Therefore, according to her
condition, auditory pseudohallucinations is suggestive of dissociative disorders which is
associated with other dimensions. According to Annabelle’s perception, she is having several
disturbances in all her senses.
QUESTION 3
Define both ‘affect’ and ‘mood’. How would you describe Annabelle’s mood and the range and
intensity of her affect
The difference between mood and affect in the MSE is subjected to some disagreements.
It typically describes the external and dynamic manifestations of a person’s internal emotional
state (Ito and Matsushima, 2016). However, mood is regarded as a person’s predominant internal

state that changes the behavioural and attitude of the person. It is also called as differentiated
specific feelings and prolonged state of disposition. Relating it to the case of Annabelle, it can be
said the intensity of mood changes rapidly wherein patient become neutral, dysphoric and
euphoric (Ander, Lempinen, Ristkari and Klomek, 2016).
In such stages, Annabelle becomes unable to experience any sort of pleasure in current
situations (Smith and et.al., 2016). This has also lead to anhedonia; hence Annabelle is having
the issue of mood swings. A person’s nonverbal behaviour such as anxiousness and flight of
ideas affects the entire behaviour and attitude and that also leads to bring many changes in
thinking and ability aspects. It can also be measured through using the parameters such as
appropriateness, intensity, range and reactivity (Belsher and et.al., 2016). Thus, according to the
situation of Annabelle, affect may be described as appropriate or inappropriate to the current
situation along with the thought content.
Annabelle has a bland affect which describes her dispersed experience and that also
shows a congruent affect. This could also lead to Schizophrenia. Hence, in such situation the
intensity of the affect may be described as normal, blunted affect and exaggerated (Adams and
et.al., 2016). Since, it is associated with depression; therefore it brings various changes in the
personality disorders. Annabelle is also having problems in speech which may be described as
having restricted affect. Henceforth, it can be said that affect and mood both changes the
intensity of thinking and behaving.
QUESTION 4
Giving examples from the Case Study, how would you describe her behaviour and her
appearance as set out in a MSE?
Health care practitioners and clinicians analyses the physical aspects such as appearance
of the patient and afterwards, they ascertain the type of domain that exists in the patient (Ito and
Matsushima, 2016). Since, Annabelle wears colourful clothes, so she might have mania; whereas
on the other hand, unkempt and dirty clothes suggests that Annabelle has depression. Annabelle
has also the sign of malnutrition as her mother stated that she does not eat properly. Under her
observation, it also includes personal hygiene analysis (Dawes and et.al., 2016). Weight loss is
also a depression disorder which she has and because of that she is having physical illness as
well.

When a patient has abnormalities in behaviour, he also experiences abnormalities in
activities. Hence, it includes observation of specific abnormal movements along with the general
movements of the patient’s level of activity and arousal. As per the behaviour, Annabelle is
having neurological disorder as she has symptoms of choreiform, athetiod or choreoathetoid.
Annabelle is also experiencing akathisia as this depicts her inability to sit (Sourander, Lempinen,
Ristkari and Klomek, 2016). This also shows a side effect of antipsychotic medication. In the
present case, the examiner has realized that Annabelle’s eyes repeatedly glances to different
sides which states that she has pseudohallucinations. However, most of the clinicians say that
lack of eye contact would be a result of depression or autism (Dawes and et.al., 2016).

REFERENCES
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Smith, E. and et.al., 2016. Preschool hyperactivity specifically elevates long-term mental health
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Sourander, A., Lempinen, L., Ristkari, T. and Klomek, A. B., 2016. 19.1 Changes in Mental
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