Psychopathology and Psychiatric Assessment
Core concepts
Master the mental state examination structure: appearance/behaviour, speech, mood and affect, thought form and content, perception, cognition, insight, and risk. Define psychopathological terms precisely - delusion (fixed false belief, held with conviction, not shared by culture), hallucination (perception without external stimulus), illusion (misperception of real stimulus), and the subtypes (grandiose, persecutory, nihilistic, Capgras, Fregoli). Distinguish thought disorder (loosening of associations, flight of ideas, thought blocking) from content abnormalities. Understand insight as a continuum and its legal/ethical implications. Learn the classification systems: DSM-5-TR and ICD-11 - their categorical vs dimensional approaches, and key divergences (e.g., ICD-11 retains subtypes of schizophrenia, DSM-5 does not; ICD-11's 'mixed' categories differ). Know screening and rating instruments (PHQ-9, GAD-7, PANSS, HAM-D, MMSE, MoCA) and their purposes.
Traps
Questions test whether you can distinguish a delusion from an overvalued idea (less conviction, culturally plausible) and from obsessions (ego-dystonic, resisted). Beware 'pseudohallucinations' and hypnagogic phenomena. The MMSE is insensitive to executive dysfunction; MoCA is better for mild cognitive impairment. Cultural context can make a belief non-delusional.
Rule of thumb
When uncertain, ask: is the belief fixed despite contrary evidence, and is it outside the person's cultural norm? If yes, it is a delusion.