Mental state examination

Question 1

What are the 7 points of the mental state examination (ASEPTIC)

Answer 1

• A - Appearance and behaviour
• S - Speech
• E - Emotion (Affect and mood)
• P - Perception
• T - Thoughts: Control and content
• I - Insight
• C - Cognition

Question 2

MSE - Appearance

Answer 2

• Age, gender, race
• Body habitus
• Grooming (Neat, unkempt)
• Attire
• Posture
• Gait, odd movements
• Evidence of injury or illness
• Smell (Alcohol, urine, vomit, BO)

Question 3

MSE - Behaviour

Answer 3

• Eye contact
• rapport
• Open, guarded, suspicious
• Agitation, psychomotor retardation
• Disinhibition, overfamiliarity

Question 4

MSE - Speech

Answer 4

• Rate (Abnormally fast, abnormally slow)
• Amount (Increase → Pressured) (Decreased → Monosyllabic → Mute)
• Variation in tone (Prosody)
• Speech delay
• Volume

Question 5

MSE - Mood

Answer 5

How do they feel today (Note this down in their own words)

Question 6

MSE - Affect

Answer 6

Observation of how they feel throughout (Baseline and any variation)

Question 7

Affect vs Mood

Answer 7

Mood stays the same usually, if you ask someone 10 minutes apart how they feel, they’ll often say the same, however, the tone and reaction to what they’ve been talking about will changes
E.g. Climate vs weather

Question 8

What are the 4 main types of affect?

Answer 8

• Reactive affect (Normal changes in emotion)
• Unreactive
• Flattened affect
• Blunted affect

Question 9

MSE - Cognition

Answer 9

• Orientation to time and place
• Concentration
• Memory

Question 10

MSE - Insight

Answer 10

• Do they recognise that they are unwell
• Do they attribute it to a mental health problem

Question 11

MSE - Perception

Answer 11

Hallucinations