Mental State Examination Flashcards
what is the difference between the information in a history and an MSE?
history = patients account MSE = your observations
what eight things are assessed in an MSE?
appearance behaviour speech affect + mood thoughts perception cognition insight
what kind of things are you looking at in the patients appearance as part of the MSE?
body habitus grooming attire posture injuries
what kind of things are you assessing when it comes to speech in an MSE?
rate
amount
tone
volume
what is a patients mood?
how they feel in the moment
what is a patients affect?
your observation of how the patient appears and reacts throughout the interview
name five ways you could describe a patients affect
reactive (normal) unreactive (no change) incongruent (inappropriate blunted (no extremes) flattened (low baseline)
what three things need to be assessed when checking cognitive function?
orientation in time, place and person
concentration
memory
what is autobiographical memory?
memory of personal events
what is retrograde memory?
memory of past events e.g. historical events
what is anterograde memory?
memory of new events e.g. remembering a list of objects
what three types of memory can be assessed as part of a cognitive assessment?
autobiographical
retrograde
anterograde
what are you assessing when looking at the patients insight in an MSE?
do the know they are unwell? and why?and do they accept that they need treatment?
what is a hallucination?
a perception which occurs in the absence of an external stimulus
what are the three types of auditory hallucinations?
second person
third person
thought echo
what is a second person auditory hallucination?
a voice that is directly addressing the patient
what is a third person auditory hallucination?
a voice which discusses the patient or provides a running commentary on their actions
what is a thought echo auditory hallucination?
a voice that repeats the patients own thoughts out loud
what are visual hallucinations often associated with?
altered consciousness
what are the two groups of visual hallucinations?
simple - flashes of light etc.
complex - faces, figures etc.
what is the passivity phenomena?
when behaviour is experienced as being controlled by someone else rather than by the individual
what abnormalities are often seen in patients with passivity phenomena, and what are these areas normally responsible for?
parietal and cingulate cortex abnormalities on PET
involved in interpretation of sensory information
what is a thought disorder?
when there is a problem with the formation of thoughts
how is a thought disorder identified?
through evidence found in the patients speech/writing
name three thought disorders
flight of ideas
loosening of associations
neologism
what happens in flight of ideas?
the patient jumps from topic to topic with recognisable but inappropriate links
what happens in loosening of associations?
patients speaks illogically and vaguely so it is difficult to follow and no information is really given
what is knight’s move thinking?
when there are jumps between topics that have no logical connection
what is neologism?
an abnormality of speech in which the patient either makes up new words or uses existing ones in bizarre ways
what is a delusion?
a false belief or a belief held on false grounds
will be firmly held no matter what
what needs to be considered when a patient presents with a delusion?
if this is having a functional impact on their lives
what themes are seen in delusions in depression?
disease nihilism poverty sin guilt
what themes are seen in delusions in schizophrenia?
control
persecution
religion
love
what themes are seen in delusions in mania?
grandiosity
persecution
religion
