Mental State Examination

Question 1

what is the mental state examination

Answer 1

areas that are observed by the clinician on taking a psychiatric history, an objective assessment

Question 2

list the components of the mental state examination

Answer 2

think ASEPTIC 
appearance and behaviour 
speech 
emotion - mood and affect 
perception 
thoughts 
insight
cognition

Question 3

list the findings when discussing appearance

Answer 3

neat or unkempt 
attire, dark or light colours 
posture/body language 
gait and odd movements such as tics and tremors
evidence of injuries and abuse 
smell --> vomit, BO, urine

Question 4

list the findings when discussing behaviour

Answer 4

eye contact
rapport with clinician
open/guarded/suspicious
psychomotor retardation

Question 5

what is psychomotor retardation

Answer 5

slowing of thoughts and lack of movement in response to information - present in depression

Question 6

what is the difference between mood and affect

Answer 6

mood is a subjective measure whereas affect is an objective measure
mood - how the patient is feeling today, record in their own words
affect - clinicians observation of how the patient appeats through the consultation

Question 7

describe the areas that are assessed when considering cognitive function

Answer 7

orientation in place and time
they know who they are, where they are, when it is
concentration - say months of the year backwards
memory - both anterograde and retrograde

Question 8

what is insight

Answer 8

the degree to which a person recognises they are unwell, very minimal in people with psychosis

Question 9

what are illness beliefs

Answer 9

the patients own explanation of their ill health, usually have their own reasoning why they are seeing the doctor

Question 10

what is perception

Answer 10

usually hallucinations that the patient may experience, a perception that occurs in the absence of external stimuli

Question 11

list the different types of hallucinations

Answer 11

auditory - either second person or third person
visual
somatic

Question 12

describe the difference between second and third person auditory hallucinations

Answer 12

second person - voice is directly addressing the patient

third person - the voice discusses the patient and provides a running commentary of their actions

Question 13

describe what patients see with visual hallucinations

Answer 13

altered consciousness with either flashes of light or images of faces or figures
often paired with somatic features such as feeling of insects on someones skin

Question 14

describe flight of ideas

Answer 14

when patient is talking, words are associated together inappropriately because of their meaning or rhyme
appears with patient jumping from topic to topic but links are recognisable

Question 15

describe loosening of associations

Answer 15

patients speech is muddles and difficult to follow, jump from topic to topic but this time there is no clear link
difficult to understand

Question 16

what are neologisms

Answer 16

patient makes up new word or uses existing words in a bizarre way

Question 17

what is a delusion

Answer 17

a fixed belief held on false grounds that is inappropriate to the patients socio-cultural background

Question 18

describe delusional themes seen in depression

Answer 18

disease, nihilism, poverty, sin, guilt

Question 19

describe delusional themes seen in schizophrenia

Answer 19

control, persecution, reference, religion