Introduction to MSE W12 Flashcards
What is the MSE?
It is the mental status exam, which is a structured approach to assessing psychological, emotional, social, and neurological functioning
It is used everyday, multiple times a day in hospital setting, and once or twice daily in community mental health settings
How is the MSE done?
It is woven into the interview, not done as a separate focused assessment by observing and asking questions
When is the MSE done?
It is completed during the initial assessment, which assists in establishing their baseline
- It is done throughout the treatment process to establish any changes in baseline
- After an injury or event that may impact mental status
- It is done constantly*
What are the 9 components of the MSE?
- Appearance and behaviour
- Mood and affect
- Speech
- Though form/process
- Thought content
- Perception
- Cognition
- Insight and judgment
- Risk assessment
Appearance:
It includes objective data
- sex
- apparent age
- height or weight
- grooming, hygiene
- eye colour, hair colour, hair length
Behaviour:
It includes objective data
- hyperactivity, restlessness, repetitive movements
- eye contact
- attentiveness
- general attitude (uncooperative, cooperative, withdrawn, passive, inappropriate)
- mannerisms, gestures
Mood:
It includes subjective data
- how are you feeling today?
- what word would you use to describe your mood?
- suicide/self-harm risk assessment
- homicide/harming others assessment
Patient may respond with feeling words:
- good, happy, cheerful
- okay, fine
- depressed, hopeless, lonely, sad, angry
- anxious, nervous, worried
Affect:
It includes objective data. This is the physical manifestation of the emotional state.
Note the range of affect, appropriateness to the situation and congruency with stated mood
BE MINDFUL OF MY OWN AFFECT
- elated, bright, animated
- hostile, fierce, disgruntled
- blunted, flat, downcast
Speech:
It includes objective data
- rate (average, slow, fast, pressured*)
- volume (loud, average, soft, variable, monotone)
- response time
- characteristics (accent, language)
- speech production (incoherent, irrelevant, pressured, minimal, slurred, hesitant)
Thought Form/Process:
It includes both objective and subjective data and is determined by the flow of conversation and quality of thoughts, it is “how” the person is thinking
It is described as:
- logical, organized, goal directed
- illogical, disorganized, non-sensical
- racing thoughts
- thought blocking, or slow, hesitant
Thought Content:
It includes both objective and subjective data
and it is “what” the person is thinking about. Pay attention to bothersome thoughts, preoccupations or symptoms of psychosis, specifically delusions
- what do you spend most of your time thinking about?
Perception:
It includes both objective and subjective data.
- hallucinations: auditory, visual, gustatory, olfactory, somatic/tactile
- illusions
- objective data; is the patient responding to internal stimuli ?
- assess the patient’s interpretation/extent of belief in them being real, and the patient’s reaction (positive or negative)
- ways of coping ?
Cognitive Functioning:
It is both objective and subjective data
- MMSE
- level of arousal (alert vs drowsy)
- orientation (person, place, time, situation)
- concentration and attention
- memory (short-term, recent, remote)
Insight:
It is the awareness of a situation
- the recognition of illness, and needing help
- motivation to work on identified problems
- stated as “full, partial, limited, impaired, none”
Judgment:
The process one uses to reach a decision or take action, it is also the ability to consider pros and cons of choices
- “poor judgment” may be demonstrated by impulsivity, engaging in actions with damaging consequences
