Mental state exam Flashcards
What is the acronym
All Sane Men Think Pizza Is Italian
Is MSE done separately to the history? Does it include what they told you previously?
At the same time as the history
No, a snapshot of how they are at that time.
What does each bit of the acronym mean?
Appearance and behaviour
Speech
Mood and affect
Thought form/content/harm
Perceptions
Iq (cognition)
Insight
What comes under appearance and behaviour?
Clothes
Look like chronological age?
Clean and tidy?
Any idiosyncracies like tics
How they respond in the interview situation- calm, friendly, upset etc.
Weird behaviours e.g. keep looking at one bit of the room
Overfamiliar?
What is under Speech?
Volume, rate, tone, rhythm
Pressured? (mania)
Slow (depression)
Does the conversation make sense?
Neologisms
What is mood split into?
Subjective and objective
What is under mood?
Subjective- how do they describe it, can use their quotes. Can use a scale 0-10
Objective- Your assessment- flat/euthymic/depressed/elated
What is affect?
physical manifestation of the internal state.
What is a reactive affect?
Normal eg. laughs at a joke
What is a delusion?
fixed, unshakable, false belief
What is under thought content?
Delusions?
Pre-occupations
Negative cognitions- guilt, helplessness, worthlessness, hopelessness
Phobias
Obsessions
What is a nihilistic delusion
think they are dead (severe depression)
What is a persecutory delusion?
They are out to get you
What is a grandiose delusion?
Think they are really important (falsely)
What is under thought form?
How thoughts link together
Logical flow
Thought disorders e.g. flight of ideas, loosening of associations, thought block
Any 1st rank schizophrenia symptoms present?- thought insertion, broadcasting, withdrawal.
What is under thoughts of harm?
Do they have thoughts about hurting themselves or ending their life. Are these thoughts, ideas or plans.
Any thoughts of harming other people?
What is under perceptions?
Different senses
Illusions
Hallucinations
Deja vu
Depersonalisation/derealisation
Responding to stimuli during the interview that is not there.
What is the difference between illusions and hallucinations?
Illusions are a misinterpretation of a stimulus
Hallucinations have no stimulus, are pathological (unless drug induced)
What do you ask to see if it is a true auditory hallucination?
Do you hear the voice from inside your head or outside like I’m speaking to you now? (outside is true)
What is a second person auditory hallucination?
The voice is talking to them (ask what it is saying)
What is a third person auditory hallucination?
The voice(s) talk about them
What is under cognition?
Orientated in time, person and place?
Also attention, concentration, recent and LT memory
AMTS a screening test
Old age- more thorough cognitive assessment- MoCA or ACE-III
What can you say if you didn’t formally assess cognition?
Cognition was not formally assessed but appeared grossly intact, and they seemed orientated by time, person and place.
What is under insight?
Do they think they are unwell
What do they think is causing?
Do they think there is treatment available to help them?
Would they agree to try it?
What is a somatic hallucination?
Feeling of things moving around inside them e.g. kidneys moving. Often schizophrenia.
What is a delusion of passivity?
Actions and feelings can be controlled or interfered with by outside influence
What is a delusion of reference?
Actions of other people/the media referring to the person or communicating a message
