20. mental state exam Flashcards
sections of a MSE
ASEPTIC
Appearance and behaviour
Speech
Emotion and Affect
Perception
Thought
Insight
Cognition
Appearance and behaviour
Describe someone so that someone could pick them out in a waiting room
Ethnicity, age, clothing, well-kempt
Body language : eye contact, rapport. E.g relaxed, agitated, intense eye contact, were able to establish a rapport, didn’t want to engage during the consultation
Abnormal movements : EPSEs - tremor, stiffness, gait, tardive dyskinesia (rhythmic abnormal movement, tongue protrusion) - it is difficult to treat. ⅓ will get better but lots of ppl it continues, oculogyric crisis
Speech MSE
Rate, tone, volume, rhythm
Fluency, coherency
Any dysphasias
Emotions/mood MSE
Objective: dysthymic, euthymic (in the middle) or elated/hyperthymic
Subjective (mood) : pt perspective/rate on a scale,
Affect : reactive (responds to humour, good news, bad mood etc)/flattened (restricted range) congruent/incongruent “in terms of emotions and mood - objectively her mood is x, subjectively she describes this as x. Her affect is x and this is mood congruent/incongruent”
Perceptions MSE
Illusions: false perception in the presence of an actual stimulus
Hallucinations
Auditory, visual, olfactory, gustatory, tactile
Thought MSE
Formal thought disorders
- circumstantiality
- tangentality
- Neoligisms
- Clang associations
- Word salad
- Knights move
- Flight of ideas
- Perseveration
- Echolalia
- Jargon dysphasia
Content
- overvalued ideas
- obsessions
- delusions
- thought alienation
- passivity
- is the thought content congruent with affect?
Insight MSE
Full, partial, none
Cognition MSE
Oriented to time place and person but not formally assessed
Attention - spell world backwards
MMSE, MOCA, ACE III
Capacity (to accept admission/treatment)
4 areas of risk assessment
To self
To others
Of exploitation
Of retaliation
what is circumstantiality
the inability to answer a question without giving excessive, unnecessary detail. However, this differs from tangentiality in that the person does eventually return the original point.
what is tangentality
wandering from a topic without returning to it.
what are neoligisms
new word formations, which might include the combining of two words.
what are clang associations
ideas are related to each other only by the fact they sound similar or rhyme
what is word salad
incoherent speech where real words are strung together into nonsense sentences
what is knights move thinking
a severe type of loosening of associations, where there are unexpected and illogical leaps from one idea to another. It is a feature of schizophrenia.
flight of ideas
thought disorder where there are leaps from one topic to another but with discernible links between them.
perseveration
Repetition of ideas or words despite an attempt to change the topic
echolaia
repetition of someone else’s speech, including the question that was asked.
overvalued ideas
somewhat shakable, not functionally impairing but they still believe it
obsessions
recurrent intrusive thought that can be associated with compulsions
delusion define
false or illogical belief that is unshakable and doesn’t fit with someone’s social or cultural background
Belief that you have more power, wealth, intelligence or grand traits than is true
delusion of grandeur
beliefs that they will be/or soon will be destitute
Delusion of poverty
belief there are parasites/bugs under skin
Parasitosis (ekoms)
