Mental state examination Flashcards
Subheadings of mental state exam
- Appearance and behavior
- Speech
- Mood and affect
- Thoughts
- Perception
- Cognition
- Insight
Mnemonic: A&B SMT PCI + !RISK!
Mnemonic for mental state exam
A&B SMT PCI
+ risk!!!!
What to note in ‘appearance and behavior’ section
Just observe, no need to ask
- appearance: dress, physical appearance, neglect
- behaviour: suspicious, paranoid, irritable, aggressive, eye contact, quiet, withdrawn, preoccupied
Speech section - what to notice
Speech - do not need to ask/assess while talking
- Rate: the pressure of speech, slow
- volume/tone: monotonous
- fluency and rhythm
How to assess ‘mood and affect’ section
Ask the patient:
- how are you feeling?
- how your mood has been?
Mood - what pt says they feel
Affect - expressed emotion
What are the components of ‘thought’ section? (2)
- form: coherence/spojnosc/, muddled, flights of ideas, knights move, preoccupation
- content: harm to self/others, suicidal ideas, delusions, over- valued ideas, thought insertion/withdrawal/broadcasting, control over thoughts
Example of questions you may ask to assess ‘thoughts’ section
Delusions: Have you noticed any strange thoughts? / thought that others find strange?
Can nayone interfere with your thoughts?
Do you feel you can control your actions?
Risk assessment: Some people may feel like harming…..
(3) components of ‘perception’ section
- hallucination ( sensory preodcupation without a stimulus
- illusion (misinterpreted stimulus)
- pseudohallucination (a hallucination a patient is aware it is not real)
What questions to ask in order to assess ‘perception’
- Have you ever heard/ seen anything you can’t explain?
- Have you ever heard people commenting on what you do?
- Do you ever feel like events have a special meaning for you?
- Have the voices ever told you to harm yourself or the others?
Cognition - what to assess
- concentration and attention
- short-term memory
- oreitnation (time/person) - mini mental state exam
What is meant by ‘insight’?
- awarness of an illness
- understanding the need for treatment and willingness to undertake it (e.g. take meds)
