Mental State Examination

Question 1

what is an MSE?

Answer 1

this is an objective assessment based on observations during the consultation

Question 2

what does the MSE consist of?

Answer 2

appearance
behaviour
speech
mood 
affect
thought
perception
cognitive function
insight

Question 3

appearance parts of the MSE

Answer 3

age
gender
race
body habitus
grooming
attire
posture
gait 
movements (tics)
evidence of injury or illness
smell

Question 4

behaviour parts of the MSE

Answer 4

eye contact
rapport
agitation
disinhibition
suspicious

Question 5

speech aspects of the MSE

Answer 5

rate
amount (pressured or monosyllabic)
tone
delay 
volume

Question 6

what is mood?

Answer 6

subjective

how the patient feels today (weather)

Question 7

what is affect?

Answer 7

observation of patient during consultation
consider baseline and extent of variation
ability to put on a mask
climate/season

Question 8

what does thought consist of?

Answer 8

1. control (form and flow)

2. content

Question 9

what can go wrong with thought control?

Answer 9

passivity phenomena

disorder of form of thought

Question 10

what can go wrong with thought content?

Answer 10

delusions

delusion theme

Question 11

what is passivity phenomena?

Answer 11

behaviour is experienced as being controlled by an external agency e.g. thought insertion, made actions and feelings

Question 12

what are some examples of disorders of flow of thought?

Answer 12

flight of ideas
loosening of associations
neologism

Question 13

what is flight of ideas?

Answer 13

words associated together inappropriately because of meaning or rhyme
jump from topic to topic

Question 14

what is loosening of associations?

Answer 14

speech is muddled with jumps from topic to topic with no logical connection (Knight’s move thinking)

Question 15

what is neologism?

Answer 15

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

Question 16

what is a delusion?

Answer 16

false belief that is inappropriate for patient’s socio-cultural background

Question 17

what is are delusion themes?

Answer 17

in depression about disease, poverty, guilt
in schizophrenia about control
in mania about grandiosity

Question 18

what can go wrong in perception?

Answer 18

hallucinations

Question 19

what is a hallucination?

Answer 19

perception which occurs in the absence of external stimuli

experienced as originating in real space and not subject to manipulation

Question 20

types of hallucinations/ sensory modalities

Answer 20

1. auditory
2. visual
3. olfactory
4. gustatory
5. somatic

Question 21

types of auditory hallucinations

Answer 21

1. second person= directly addresses the patient
2. third person= discusses the patient or provides running commentary of actions
3. thought echo

Question 22

types of visual hallucinations

Answer 22

simple (flashes of light)

complex (face or figure)

Question 23

examples of somatic hallucinations

Answer 23

bodily sensations e.g. insects crawling or being touched

Question 24

three aspects of cognitive function

Answer 24

1. orientation to time, place and person
2. concentration
3. memory

Question 25

testing concentration in cognitive function

Answer 25

months in reverse order

Question 26

aspects of memory in cognitive function

Answer 26

autobiographical
retrograde
anterograde

Question 27

what is insight?

Answer 27

whether the patient recognises they are unwell, realise it is mental health and accept the need for treatment