Mental State Examination Flashcards
MSE exam
Appearance and Behaviour Speech Mood and affect Thought Perception Cognition Insight
Appearance and Behaviour
Dress Kempt/ unkempt Level of psychomotor activity Abnormal movements Appropriateness of behaviour Level of anxiety/ restlessness/ agitation Distractibility Eye contact Rapport
Speech
Rate Rhythm Volume Quantity Fluency Abnormal associations Formal thought disorder?
Mood
Objectively - what you see
Subjectively - 0-10
Mood and affect
Enjoyment Energy Biological - Sleep - Appetite - Concentration/ memory - Libido Psychological features - Future? - Hopelessness - Suicide risk Suicide - Thoughts - Self harm - Protective factors
Depression Mood and Affect
Anhedonia Decreased energy Early morning waking Reduced appetite/ increased Reduced libido Suicide Hopelessness
Mania Mood and Affect
Excess enjoyment Increased energy Reduced sleep Reduced appetite Reduced concentration and memory (although they think it's great) Increased libido
Thought
Form Content - Obsessions - Delusions - Specific content delusions: persecutory, mood congruent, schizophrenia (thought insertion, extraction, control and reference)
Thought Form Depression
Poverty of thought
Thinking is slow and laboured
Thought Form Mania
Pressure thought
Spuriously connected, rhyming, flight of ideas, often funny
Thought Form Psychosis
Loss of association
Derailment, difficult to follow train of thought
Thought Form Cognitive Impairment
Circumstantiality
Meandering speech covering up for impairment
Thought Content
Normal
Obsessions
- Recurrent intrusive thoughts
- Recognise as their own
- Generates anxiety
- Trying to resist = compulsive actions
Delusions
- Fixed false beliefs out of keeping with social, cultural, education and religious norms
- Need to challenge to ensure they are fixed
Specific delusions
- Persecutory: most common, ‘MI5 are after me’, need to ask harm to others/ themselves
- Mood congruent: depression = nihilistic (‘done something terrible’, guilt, dead inside), manic = grandiose (God)
- Schizophrenia: thought insertion, thought extraction, control, reference
Perception
Normal
Illusion
- Misinterpretation of an external stimulation
Hallucination
- Perception without external stimulation
- Auditory: psychosis mostly
- Visual: organic cause/ drugs/ mental illness
- Olfactory/ gustatory: Epileptic activity/ mental illness
- Somatic/ tactile: rare, drug use/ alcohol withdrawal/ mental illness
Cognition
Time
Place
Person
If not orientated than do full cognitive exam e.g. MOCA, ACE
