Mental State Exam Flashcards
What is the general layout of a mental state exam?
1) Appearance and behaviour
2) Mood
3) Speech
4) Thoughts (form, content)
5) Perceptions
6) Cognition (orientated, concentration)
7) Insight into illness
When assessing appearance in an MSE what do you look for?
1) Dress
- loose (anorexia)
- dishevelled (psychosis or dementia, alcohol, depression.)
- brightly coloured (mania)
2) Evidence of self harm - cuts? Brusing?
3) Evidence of physical neglect - personal hygeine?
4) Evidence of physical illness e.g. hyper or hypothyroidism, cushing’s disease.
when assessing behaviour in an MSE what do you look for?
- quality of rapport
- eye contact
- tearful / anxious suspicious
How do you assess a patient’s mood in an MSE?
- How are you feeling in your spirits?
- having you had any episodes of feeling sad or miserable?
- how bad does it get / has it got?
- Have you ever felt on top of the world like you could do anything
- Does your mood vary?
- do yu find yourself getting tearful
- suicidal intentions : do you ever feel hopeless? have you ever thought of ending your life?
What do you assess in a patient’s speech during an MSE exam?
- tone
- rhythm
- rate
- volume
How do you assess in the patient’s thought process in an MSE exam?
1) Form - is it coherent.
2) Content
- worries/preoccupations/obsessional ruminations
- self harm thoughts
- abnormal thoughts
- have you ever felt like people were against you?
- have there been times when you felt something strange was going on?
- have your thoughts been directly interfered with by some outside force or person?
How do you assess the patient’s perceptions in an MSE exam/
“I’d like to ask a routine question we ask everyone - have you ever had experience of hearing noises or voices but when you look there is no one there and nothing to explain it”
How do you assess the cognition of a patient in an MSE?
- is the patient orientated in time, place and person.
concentration - list months in reverse order.
Other cognitive test funcion e.g. mini mental state exam / AMTs
How do you assess the patient’s insight into their illness in an MSE?
- do you think there has been a change in your mental health?
- what do you think may be causing it?
- do you think you need any treatment?
