Mental state exam

Question 1

What is the acronym

Answer 1

All Sane Men Think Pizza Is Italian

Question 2

Is MSE done separately to the history? Does it include what they told you previously?

Answer 2

At the same time as the history

No, a snapshot of how they are at that time.

Question 3

What does each bit of the acronym mean?

Answer 3

Appearance and behaviour

Speech

Mood and affect

Thought form/content/harm

Perceptions

Iq (cognition)

Insight

Question 4

What comes under appearance and behaviour?

Answer 4

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?

Question 5

What is under Speech?

Answer 5

Volume, rate, tone, rhythm

Pressured? (mania)

Slow (depression)

Does the conversation make sense?

Neologisms

Question 6

What is mood split into?

Answer 6

Subjective and objective

Question 7

What is under mood?

Answer 7

Subjective- how do they describe it, can use their quotes. Can use a scale 0-10

Objective- Your assessment- flat/euthymic/depressed/elated

Question 8

What is affect?

Answer 8

physical manifestation of the internal state.

Question 9

What is a reactive affect?

Answer 9

Normal eg. laughs at a joke

Question 10

What is a delusion?

Answer 10

fixed, unshakable, false belief

Question 11

What is under thought content?

Answer 11

Delusions?

Pre-occupations

Negative cognitions- guilt, helplessness, worthlessness, hopelessness

Phobias

Obsessions

Question 12

What is a nihilistic delusion

Answer 12

think they are dead (severe depression)

Question 13

What is a persecutory delusion?

Answer 13

They are out to get you

Question 14

What is a grandiose delusion?

Answer 14

Think they are really important (falsely)

Question 15

What is under thought form?

Answer 15

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.

Question 16

What is under thoughts of harm?

Answer 16

Do they have thoughts about hurting themselves or ending their life. Are these thoughts, ideas or plans.

Any thoughts of harming other people?

Question 17

What is under perceptions?

Answer 17

Different senses

Illusions

Hallucinations

Deja vu

Depersonalisation/derealisation

Responding to stimuli during the interview that is not there.

Question 18

What is the difference between illusions and hallucinations?

Answer 18

Illusions are a misinterpretation of a stimulus

Hallucinations have no stimulus, are pathological (unless drug induced)

Question 19

What do you ask to see if it is a true auditory hallucination?

Answer 19

Do you hear the voice from inside your head or outside like I’m speaking to you now? (outside is true)

Question 20

What is a second person auditory hallucination?

Answer 20

The voice is talking to them (ask what it is saying)

Question 21

What is a third person auditory hallucination?

Answer 21

The voice(s) talk about them

Question 22

What is under cognition?

Answer 22

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

Question 23

What can you say if you didn’t formally assess cognition?

Answer 23

Cognition was not formally assessed but appeared grossly intact, and they seemed orientated by time, person and place.

Question 24

What is under insight?

Answer 24

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?

Question 25

What is a somatic hallucination?

Answer 25

Feeling of things moving around inside them e.g. kidneys moving. Often schizophrenia.

Question 26

What is a delusion of passivity?

Answer 26

Actions and feelings can be controlled or interfered with by outside influence

Question 27

What is a delusion of reference?

Answer 27

Actions of other people/the media referring to the person or communicating a message