MENTAL STATE EXAM Flashcards
MENTAL STATE EXAM
what are the components?
- appearance and behaviour
- speech
- mood and affect
- thought
- perception
- cognition
- insight and judgement
- risk
APPEARANCE
what are you looking for?
- personal hygiene
- clothing (appropriately dressed?)
- physical signs of underlying difficulties (self harm)
- stigmata of disease
- weight
- objects
BEHAVIOUR
what should you look for?
- engagement and rapport
- eye contact
- facial expressions
- body language
- psychomotor activity
- abnormal movements or postures
SPEECH
what should you look for?
- rate of speech
- quantity of speech
- tone of speech
- volume
- fluency + rhythm
MOOD
what should you ask?
- how are you feeling?
- what is your current mood?
- have you been feeling low/depressed/anxious lately?
AFFECT
what are you looking for?
- apparent emotion
- range and mobility of affect
- intensity of affect
- congruency of affect
THOUGHT
what are the different components of thought?
- thought form
- thought content
- thought possession
THOUGHT
what should you look for in thought form?
- speed of thoughts
- flow and coherence of thoughts e.g. flight of ideas, thought block
THOUGHT
how would you explore thought content?
“What’s been on your mind recently?”
“Are you worried about anything?”
“Do you sometimes have thoughts that others tell you are false?”
“Do you have any beliefs that aren’t shared by others you know?”
“Do you ever feel that people are out to harm you?”
“Do you ever feel that specific events in the world relate to you somehow?”
“Are there any thoughts you have a hard time getting out of your head?”
“Do you sometimes feel the need to perform certain behaviours repetitively, despite understanding these are irrational?”
“Do you ever think about ending your life?”
“Have you ever felt your life was not worth living?”
“Have you ever attempted to end your life?”
“Have you ever harmed yourself to cope with difficult emotions”?
“Do you ever think about harming others?”
THOUGHT
what are the different types of thought possession?
- thought insertion
- thought withdrawal
- thought broadcasting
THOUGHT
how could you explore thought possession?
INSERTION
“Do you think people can put ideas in your head without your control?”
WITHDRAWAL
“Have you ever felt like people have removed memories or thoughts from your mind?”
BROADCASTING
“Do you ever feel like others can hear your thoughts?”
PERCEPTION
what should you be looking for?
- hallucinations
- illusions
- depersonalisation
- derealisation
PERCEPTION
how would you explore it?
“Do you ever see, hear, smell, feel or taste things that are not really there?”
“Did you think this was real at the time?”
“Do you still believe it was real?”
“Do you ever feel as though you’re not real?”
“Do you ever feel like you’ve changed or that you don’t recognise the person you currently are?”
“Do you ever feel like the world around you isn’t real?”
COGNITION
how would you assess cognition?
- see if they are orientated in time, place and person
- assess their attention span and concentration levels
- assess their short term memory
INSIGHT
how would you assess insight?
“What do you think the cause of the problem is?”
“Do you think you have a problem at the moment?”
“Do you feel you need help with your problem?”
JUDGEMENT
how would you assess judgement?
- “What would you do if you could smell smoke in your house?”
RISK
what are the different components of risk?
- risk to self
- risk to others
- risk from others
RISK
how would you assess risk to self?
“Sometimes, when people are going through difficult things, they might have thoughts of wanting to harm themselves – is this something you’ve experienced?”
“Do you have any plans to act on those thoughts?”
“People can sometimes hurt themselves to manage overwhelming emotions or feelings of numbness– is this something you’ve ever done? If so, how do you cope with these feelings?”
RISK
how would you explore risk to others?
“Sometimes, when people are going through difficult things, they might have thoughts to harm someone else. Is this something you’ve experienced?”
“Do you have any plans to act on those thoughts?”
