Depression | Mental State Examination (MSE) | OSCE Guide | SCA Case | UKMLA | CPSA | PLAB 2

Summary

In this psychiatric assessment, Dr. Jade interviews Jane Sheraton, a 48-year-old woman struggling with severe depression and suicidal thoughts. Jane reveals feelings of hopelessness, guilt, and social isolation, stemming from the recent loss of her job and financial difficulties. She is stockpiling paracetamol with thoughts of suicide, although uncertain about acting on them. The assessment highlights her self-neglect, poor sleep, and lack of interest in activities she once enjoyed. The conversation underscores the importance of empathetic care, addressing both mental health and social factors to ensure Jane’s safety and initiate appropriate support.

Takeaways

• 😀 Jane is a 48-year-old woman experiencing severe sadness and hopelessness after losing her job, which has led to emotional distress and suicidal ideation.
• 😀 Jane reports a lack of interest in activities she once enjoyed, such as running, indicating anhedonia, a key symptom of depression.
• 😀 She has been struggling with poor sleep, often waking up early with overwhelming negative thoughts about her perceived failures.
• 😀 Jane has been stockpiling paracetamol with thoughts of suicide, though she is unsure whether she would actually follow through with her plan.
• 😀 She expresses feelings of guilt, burdening others, and believes her family and friends would be better off without her.
• 😀 During the mental state examination, Jane appeared tearful and showed psychomotor retardation, with slow and monotonous speech.
• 😀 Jane's cognitive distortions, such as hopelessness and guilt, were evident, although she denied perceptual abnormalities or delusions.
• 😀 Despite her distress, Jane demonstrated partial insight into her situation, but she does not fully recognize that her feelings may be related to a mental health disorder.
• 😀 Jane denies any thoughts of harming others, and there is no evidence of paranoia or delusions during the assessment.
• 😀 The psychiatrist assesses Jane as being at high risk for self-harm due to her ongoing suicidal thoughts and self-neglect, highlighting the need for immediate intervention and safety measures.

Q & A

What is Jane Sheraton's current emotional state as described in the interaction?

Jane is experiencing a low mood, sadness, and has been crying frequently. She reports feeling hopeless, guilty, and burdened by recent events, particularly the loss of her job.

What recent life event contributed significantly to Jane's emotional distress?

The most significant event was Jane losing her job, which has made her feel like she has let down her family, particularly her son. She is also worried about her financial situation and being unable to support her son’s education.

How long has Jane been feeling this way?

Jane reports that she has been feeling sad and distressed for a few weeks.

How has Jane been coping with her feelings of distress?

Jane has stopped engaging in activities she once enjoyed, such as running, and no longer socializes with friends. She also has difficulty sleeping, waking up in the middle of the night consumed by feelings of guilt and hopelessness.

Has Jane been able to maintain her self-care?

No, Jane admits that she has been struggling with self-care, such as eating. She mentions only eating small amounts of toast and feels that she does not see the point in taking care of herself.

Has Jane ever thought about harming herself?

Yes, Jane admits to having thoughts of self-harm, including considering taking an overdose of paracetamol. She feels that others would be better off without her and has even thought about writing a note for her son.

What were Jane’s thoughts regarding her family and loved ones?

Jane feels a deep sense of guilt and believes she has let her family down, particularly her son. She feels unable to provide for him and has thoughts of being a bad mother due to her financial struggles.

What did Jane say about her thoughts of ending her life?

Jane expressed that she doesn’t know if she would actually take her life, but she feels overwhelmed by her emotions and has considered ending it. She stockpiled paracetamol, but she is unsure if she would go through with it.

What mental health symptoms did Jane display during the assessment?

During the assessment, Jane appeared sad and tearful, had poor eye contact, and showed evidence of psychomotor retardation. Her speech was slow and monotonous, and she displayed signs of anhedonia (lack of interest in pleasurable activities), poor concentration, and early morning waking.

Was there any indication that Jane was experiencing hallucinations or delusions?

No, Jane denied experiencing hallucinations or delusions. She did not report any abnormal thoughts such as hearing voices or feeling controlled by others.

What did the healthcare professional (Jade) conclude after the assessment?

Jade concluded that Jane is at significant risk due to her ongoing suicidal ideation and the plans she has made to take paracetamol. Jane also appears to be at risk of self-neglect. Jade recommended speaking with her team to determine appropriate steps for further help.