Mental state examination - Lecture Flashcards
Outline general overview of MSE- ? general overview
Appearance on MSE? Describe patient well enough to be able to pick them out of a waiting room-?
Demographics, Gender, apparent age, ethnicity, clothing, make-up, hygeine, smell
Behaviour in MSE?
e.g (facial expression, posture, eye contact, rapport, level of arousal (calm/agiated), anxious or aggressive behaviour, pyshcomotor activity and movement)
Describe and give example of a patients appearance and behaviour?
Describe speech in terms of MSE?
Speech rate, volume, tone, quanity, latency (time between words sentences), fluency, other terms: echolalia, coprolalia, glossolalia, peravatives, neologism)
Give some examples of speech in different psychiatric conditions?
Describe mood in MSE? e.g How do you feel right now? How would you describe your mood?
its subjective to pt
Describe affect in MSE?
Comment on- is external expression of internal emotions (e.g what you see communicated through facial expression)
Changeability/stability-
Appropriateness- congruent with emotions
Range- of their affect- how different are the different
Reactivity-
Guve some examples of affect in MSE—-?
Describe what is meant by “Thought form”, in an MSE?
-Best assessed after asking a question and seeing how directly or indirectly the question is asked
Thought form- Normal, linear, rational,
circumstantial- get off topic but back to the answer
tangential- think of like a tree branch ,
loose associations and or derailment- (e.g- jump from one idea to another),
flight of ideas (jump from one idea to another by superficial links- e.g but going all over the place but some small links)
word salad-incoherent/nonsense
Others: Clang associations- talking in rhyming words
Echolalia, neologisms
Thought blocking- Like they had a thought and when they are talking they stop….mid sentence… and lost words/distracted etc. (THEY loose their thought)
Describe “thought content”, in MSE? You gain all this information from asking all q’s related to illness…
What are the predominant themes in the patients account of themselves?
Overvalued ideas= illogical or flase idea that is held relatively firmly, thought not quite of delusional intensity)
Delusions= objectively incorrect beliefs, not culturally determined or shared with a large group. These beliefs can NOT be shaken by contrary evidence.
Grandiose
Erotomanic
Nihilistic
Comment on suicidal or homicidal ideation
Give some examples of thought content” in MSE?
Describe perception in MSE? (hallucinations vs illusions)
Describe Cognition in MSE
What formal tests can we perform to assess cognition?
Orientation- location, day, time, people around them
Attention and concentration–
Registration and recall
Memory- Can they rememeber what they had for breakfast? whats in the news recently? For long term memory ask about significant world events?
MMSE, MOCHA, KICKA, Frontal lobe assessment, ACE- R - types of assessments
Describe what “insight” is in an MSE?
–Multifaceted concept
Do they believe their symptoms are “real”?
Does the person believe they are suffering from a Mental illness?
Do they believe they might benefit from treatment?
If not, why not? Are they aware of their options?
Do they recognise risks associated with their situation and condition?
Describe what is meant by “judgement”, in an MSE? (Goes hand in hand with insight)
Give some examples of “insight and judgement” in MSE mental illness?
