Mental state examination Flashcards
What factors can be commented on in ‘appearance’ in MSE?
distinguishing features - scars, tattoos, signs of IVDU
weight - under/overweight
stigmata of disease
personal hygiene - gives insight into patient’s current ability to care for themselves
clothing - appropriate for weather
objects - if they’ve brought anything with them
What factors can be commented on in ‘behaviour’ in MSE?
engagement + rapport
eye contact - reduced or excessive
facial expression
body language
psychomotor activity
abnormal movements or postures eg. tremors, rocking, tics
What factors can be commented on in ‘speech’ in MSE?
rate of speech
quantity of speech
tone of speech
volume of speech
fluency + rhythm of speech
What’s the difference between mood and affect?
affect = immediately expressed and observed emotion
mood = predominant subjective internal state at any one time as described by them
affect is what you observe, mood is what the patient tells you
What is meant by loose associations?
moving rapidly from one topic to another with no apparent connection between the topics
What is meant by circumstantial thoughts?
thoughts which include lots of irrelevant and unnecessary details
What is meant by tangential thoughts?
digressions from the main conversation subject, introducing thoughts that seem unrelated, oblique and irrelevant
What is meant by flight of ideas?
accelerated tempo of speech
excited speech wanders off the point following the arbitrary connections, and the coherent progression of ideas tends to become obscured
What is meant by thought blocking?
sudden cessation of thought, typically mid-sentence, with the patient unable to recover what was previously said
What is meant by perseveration?
refers to repetition of a particular response (such as a word, phrase or gesture) despite the absence/removal of the stimulus (eg. a patient is asked what their name is and they continue to repeat their name as the answer to all further questions)
What is meant by clang association?
connected by something other than meaning eg. rhyming
What is meant by neologisms?
words a patient has made up which are unintelligible to another person
What is meant by word salad?
random words without any logic
What is meant by poverty of speech?
little content, not conveying much meaning
What are delusions?
firm, fixed belief based on inadequate grounds, not amenable to a rational argument or evidence to the contrary and not in sync with regional and cultural norms
