Mental Health Assessment/Mental State Examination (MSE) Flashcards
1
Q
Why do an MSE?
A
- Identify signs & symptoms
- Monitor change or improvement
- May inform treatment or interventions
- Provides a standardised form of documentation
2
Q
When to conduct an MSE?
A
- During admission
- In the course of taking history
- If there is any change in clinical presentation
- On one to one interaction
- Informally: MH nurses conduct MSE constantly
3
Q
What is included in history taking in addition to MSE?
A
- Individual details
- Identifying the presenting problems
- History of presenting illness
- Personal history
- Previous medical/surgical history
- Family history
- Premorbid personality
- Prescribed/non-prescribed substance use
4
Q
Overview of mental state examination
A
- Appearance & Behaviour
- Speech
- Mood & Affect
- Form of thought
- Content of thought
- Perceptual disturbances
- Sensorium & cognition
- Insight / Judgement / Memory
5
Q
Appearance & Behaviour
A
- The persons appearance in relation to their mental health
- Eye contact
- Individuals reaction to present situation…is it appropriate?
- Individuals motor activity/inactivity
- Expressive gestures
6
Q
Speech
A
- Articulation disturbances
- Rate (rapid, pressured, slow)
- Volume
- Quantity
7
Q
Mood and Affect
A
Mood
- subjective/ internal feeling state
- use patients own words
Affect
- objective/observable emotions
- Range & intensity
- Stability
- Appropriateness & congruity
8
Q
Range and intensity of affect
A
Variations may range from lack of emotional expression to emotional expressiveness e.g sadness, anger, happiness etc
- Normal affect - variations in facial expressions, use hands, body movements or laughter
- Restricted affect - decrease in intensity & range of emotional expressions
- Blunted affect - severe decrease in intensity & range of emotional expressions
- Flat affect - total or near absence emotional expressions
9
Q
Stability of affect
A
Rate at which affect changes
- Stable - no fluctuation in affect
- Labile - excessively rapid changes in affect
- Diurnal variation
10
Q
Appropriateness & congruity of affect
A
- Appropriate & congruent to topic of conversation or situation e.g. sadness at funeral, laughter at joke
- A person may claim to be blind, paralysed yet show no concern for his fate, or for the impact of symptoms on his life
11
Q
Thought form/process
A
Thought form/process refers to organisation, flow & production of thought & include:
- Amount of thought & its rate of production
- Continuity of ideas
- Disturbances of language
- Logical / linear or irrational
12
Q
Amount of thought & its rate of production
A
- Poverty of ideas - absence or near absence of spontaneous speech or talk
- Flight of ideas - abrupt changes in conversation, where there is no common connection in the ideas expressed
- Slow or hesitant thinking - reduced amount of thoughts
13
Q
Continuity of ideas
A
- Perseveration- persistent repetition of the same words or themes
- Thought blocking - abrupt interruption to the flow of thinking where thoughts are completely absent for a period of time
- Distractible speech - repeated changes of topic in response to nearby stimuli
- Irrelevance - replies to questions are not related to main topic of discussion
14
Q
Disturbances of language
A
Refers to use of language or words that do not exist & include:
- Neologisms - creation of new words that have no significance or meaning to others
- “Word Salads” and incoherence’s - communication is disorganised & senseless
15
Q
Thought content
A
- What is going through the persons head?
- delusions
- obsessions/intrusive thoughts
- compulsions
- Suicidal thoughts?
- Thoughts to harm others?
- What’s for dinner?
