Mental state exam (MSE) Flashcards
first thing you do in MSE
write down patients name, DOB/DHI, date, time, your name and signature
what is the pneumonic for remembering the categories of MSE
ASEPTIC
A =
appearance and behaviour
S =
speech
P =
perception
T =
thoughts
E =
emotion - mood and affect
I =
insight
C =
cognition
what do you comment on in appearance
age, BMI, gender, race grooming - neat/disheveled clothes - bright/dark posture - slumped self harm?
what do you comment on in behavior
eye contact rapport appropriate behavior? engagement with Qs? body language withdrawn/agitated
what do you comment on in speech
fast/slow
pitch - monotomous
interruptible/pressured?
amount - increased or decreased
interruptible speech
mania
what do you comment on in emotion
mood - how are THEY feeling (use own words)
affect - how do they appear to you flat, low, depression anxious, irritated, angry elated euthymic (normal)
what do you comment on in perception
hallucinations - 2nd person, 3rd person, visual
delusions - religious, grandiose
what do you comment on in thoughts
form - flowing, logical, tangential, flight of ideas, knights move thoughts
passivity phenomena - thought interference eg thought insertion/blocking/broadcasting/withdrawal
content - negative, suicidal, their own thoughts?
what do you comment on in insight
yes or no (can ask)
what do you comment on in cognition
can do MMSE/adenbrookes if time
orientation - day, date, time, place, building, name, age DOB
concentration and attention - months of year in reverse order
memory - anterograde (recent), retrograde (past), personal
flight of ideas
quickly changing topic of conversation, but understand how they got there
in mania
knights move thought
what does it occur in
quickly changing topic of conversion, don’t know how they got form A to B
in schizophrenia
what does rhyming and punning of words occur in
mania
3rd person auditory hallucination
what does it occur in
people speaking about you across the room
schizophrenia
verbigeration
obsessive repetition of random words
delusion
a belief that is fixed and falsely held, conflcits with reality
paranoia
feeling of being threatened eg someone watching you, or acting against you, with no proof/rationale why
gedakenlantwerden
hallucination with voices speaking their thoughts at the same time they think them
folie a deux
delusions shared by 2 people closely related eg married couples
psychomotor retardation
what does it occur in
slowing of movements eg speech, walk
depression
flashback
what does it occur in
flashback - re-experiencing of event, NOT just a memory
PTSD
depersonalisation
cant feel emotion
mitgehen
excessive movements, eg slight nudge would cause exaggerated movement
nilhilistic delusions
what syndrome are they associated with
delusions of having no organs/being dead (nil = none)
cotards syndrome
psychomotor agitation
what does it occur in (3)
rapid speech, restlessness, pacing around room, tapping toes
psychosis, mania, anxiety
hallucination
false sensory perception without external stimulus eg seeing people in your house
psuedohallucination
hallucination but you know its not real
illusion
false sensory perception of real external stimulus eg mistaking a shadow for a person
tactile hallucination occurs in
alcohol withdrawal
visual hallucinations occur in
organic cause eg tumour, lewy body dementia, delirium (think of people in care home)
