A patient with schizophrenia is informed by a social worker that their father had been killed in a fire. The patient showed no sign of emotion which was considered to be odd as the two were thought to have had a very close relationship. What is suggested by the patient's response?
Mental state exam (mood and affect)
A feeling is an active experience of somatic sensation (such as touch, or heat) or a passive subjective experience of an emotion. An emotion is best thought of as a feeling and memory intertwined. A feeling is usually used to describe a reaction (positive or negative) towards an experience. Affect is used to describe a patient's present emotional responsiveness (indicated by facial expression and tone of voice). Mood is a more prolonged prevailing state or disposition. Mood and affect are usually distinguished by duration where affect is momentary and mood is more prolonged. Apathy is the absence of feeling.
Affect
Affect can be described as (in order of degree):
- Within normal range
- Constricted (affect restricted in range and intensity)
- Blunted (same as constricted but a bit more so)
- Flat (virtually no signs of affective expression)
