Mental state examination

Question 1

What is a mental state examination?

Answer 1

An assessment of a person’s current state of mind. Carried out as you take a psychiatric history and includes your observations and answers to specific questions. Should allow someone else to imagine the person from your description.

Question 2

What are the 7 sections of a mental state examination?

Answer 2

1) Appearance and behaviour
2) Speech
3) Mood and affect
4) Thought form and content
5) Perception
6) Cognition
7) Insight

Question 3

What is mood and how do you assess it?

Answer 3

Mood is a person’s emotional state overall. Can be subjective (ask the patient) and objective- can be euthymic (normal), elevated/elated, low/depressed or anxious.

Question 4

What is a person’s affect?

Answer 4

Changes in the persons emotions that observe moment-to-moment during the interview.

Question 5

Affect: reactive.

Answer 5

Appropriate reaction to the situation or topic being discussed.

Question 6

Affect: flattened.

Answer 6

Limited emotional reaction.

Question 7

Affect: blunted.

Answer 7

No observed emotional reactions (specifically associated with psychosis).

Question 8

Affect: labile.

Answer 8

Excessive emotional fluctuations.

Question 9

Thought form. What is “flight of ideas”?

Answer 9

Rapid flow of speech, moving from topic to topic with logical connections (eg. mania).

Question 10

Thought form. What is “loosening of associations/knight’s move thinking”?

Answer 10

Little or no logical connections between thoughts (eg. schizophrenia).

Question 11

What is a delusion?

Answer 11

A fixed, false belief that is out of keeping with the person’s religious and cultural background (eg. psychosis).

Question 12

Delusion: persecutory

Answer 12

Perceived threat from others.

Question 13

Delusion: grandiose

Answer 13

Considerable overestimate of abilities or possession of special powers.

Question 14

Delusion: nilihistic

Answer 14

Belief that they are dead or do not exist.

Question 15

Delusion: delusions of reference

Answer 15

Belief that external events/objects are directly related to them (eg. TV programme).

Question 16

Delusion: thought interference

Answer 16

Insertion, withdrawal or broadcast.

Question 17

Thought content: over-valued idea

Answer 17

A false belief, not totally fixed but causing great disability (eg. anorexia, hypochondriasis).

Question 18

Thought content: obsessions

Answer 18

Recurrent, intrusive, distressing ideas, impulses or images that the patient recognises are their own (eg. OCD).

Question 19

What is a hallucination?

Answer 19

Perception without external stimulus. Can occur in any sensory modality. Auditory often associated with psychosis. Visual, olfactory, gustatory, tactile are more often associated with organic states.

Question 20

What is an illusion?

Answer 20

False perception of a real stimulus (eg. seeing a person in a shadow).

Question 21

How do you assess cognition?

Answer 21

Assess alertness, orientation,, attention/concentration, memory. Possibly complete a mini mental state examination (MMSE).