Mental State Examination

Question 1

What are the elements of mental state examination?

Answer 1

Appearance and Behaviour 
Speech
Affect and mood
Thoughts: control & content
Perception
Cognition
Insight

Question 2

What is observed in appearance?

Answer 2

Age, gender, race
Body habits
Grooming
Attire
Posture
Gait, odd movements
Evidence of injury/self harm
Smell

Question 3

What is observed in behaviour?

Answer 3

Eye contact
Rapport
Open/guarded/suspicious
Agitation/psychomotor retardation
Disinhibition/overfamiliarity

Question 4

What is examined during speech?

Answer 4

Rate
-abnormally fast or slow
Amount
-increased -> pressured
-decreased -> monosyllabic -> mute
Variation in tone (prosody)
Speech Delay 
Volume

Question 5

What is observed during mood?

Answer 5

Subjective
How does the patient feel today
How are you doing?
Note down the patients own words

Question 6

What is examined in cognitive function?

Answer 6

Orientation to time, place, person
Concentration
Memory

Question 7

What questions may be asked in gauging orientation to time place person?

Answer 7

What is todays date?
What day?
What time?
What year?
Where are we now?
What floor?
What is your name, age, DOB?

Question 8

What may be asked to gauge concentration?

Answer 8

Can you go through the months of the year in reverse order?

Digit span? Spelling a word backwards?

Question 9

What may be asked to gauge memory?

Answer 9

Autobiographical memory: personal events coherent history
Retregrade memory: past events, date of 2nd world war, things on TV
Anterograde memory: new memories, remember three things- name and address

Question 10

How do you gauge insight?

Answer 10

Does the patient know they are unwell?
Do they attribute it to a mental health problem?
Do they accept the need for treatment?
Hospitalisation?