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Sem 1 Concepts Exam > Mental Status Exam > Flashcards

Mental Status Exam Flashcards

1
Q

what is the purpose of the mental status exam

A
  • to assess the psychological, emotional, social and neurological functioning of the patient
  • objectively describe the behaviours, thoughts, feelings and perceptions of the patient thru out the interview
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2
Q

How is the MSE done?

A
  • during the interview (woven in)
  • gather objective data (only from me) & subjective from patient
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3
Q

When is the MSE done?

A
  • during initial assessment
  • throughout treatment process to establish changes in baseline, response to treatment
  • when behavioural changes are evident
  • after an event to injury that may impact mental status
  • all the time!
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4
Q

what are the 9 components of an MSE

A
  1. appearance & behaviour
  2. mood & affect
  3. speech
  4. thought form/process
  5. thought content
  6. perception
  7. cognition
  8. insight & judgement
  9. risk assessment
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5
Q

what is included under “appearance”

A
  • Sex (M/F/NB/Trans etc)
  • apparent age
  • height/weight
  • ethnicity/race
  • grooming/hygiene
  • distinguishing features
  • eye colour, hair colour & length
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6
Q

what’s included under “behaviour”

A
  • psychomotor retardation or agitation
  • hyperactivity, restlessness, repetitive movements
  • eye contact (prolonged, intense, minimal etc)
  • attentiveness
  • mannerisms, gestures
  • general attitude (uncooperative, withdrawn etc)
  • attitude towards interviewer (neutral, positive etc.)
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7
Q

what’s included under “mood”

A
  • subjective data
  • “how are you feeling today?”
  • “is there any pattern to these mood changes?”
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8
Q

what’s “affect”

A
  • objective data
  • elated, bright, animated
  • blunted, flat, downcast
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9
Q

what does blunted mean

A

little emotion

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10
Q

what does flat mean

A

no emotion (schizophrenia/negative symptoms)

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11
Q

Affect not congruent with mood can indicate

A

= negative symptom of psychosis, or can indicate what someone is dealing with internally/internalizing feelings

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12
Q

what’s “speech”

A
  • objective data
  • rate of speech
  • volume/tone
  • characteristics: accent, language
  • ## response time (latency?poverty of speech?)
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13
Q

what is meant by “thought form/process”

A
  • objective and subjective data
  • determined by the flow of conversation and quality of thoughts
  • “how” the person is thinking
  • determined by speech and how they describe thinking
  • e.g., logical, organized, goal directed vs. illogical, disorganized, racing thoughts etc.
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14
Q

what is “thought content”

A
  • objective and subjective data
  • “what” the client is thinking about
  • looking for: bothersome thoughts, symptoms of psychosis, delusions, phobias or obsessions
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15
Q

what are delusions

A

thoughts or beliefs (i.e., paranoia, grandiosity etc)

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16
Q

what are hallucinations

A

5 senses: experiencing things that are/aren’t there
- auditory
- visual
- gustatory
- olfactory
- somatic/tactile

17
Q

what are Illusions

A

different from hallucination as an illusion is a misrepresentation of an object that exists (e.g., interpreting pen as a snake = illusion; hallucination = seeing a snake when nothing is there)

18
Q

what is “perception”

A
  • objective and subjective data
  • hallucinations
  • command hallucinations
  • illusions
  • objective data: responding to internal stimuli?
  • assess the content of hallucinations
19
Q

“cognition” or cognitive functioning

A
  • objective and subjective data
  • MMSE
  • level of arousal
  • orientation
  • concentration & attention
  • memory (short & long term)
  • intellectual capacity/knowledge
  • abstraction/concrete
20
Q

what is “insight”

A
  • awareness of situation, context
  • recognition of illness, need for help
  • understanding of factors contributing to illness
  • motivation to work on identified problems
  • understanding of what you should or shouldn’t do
  • stated as “full, partial, limited, impaired or no”
21
Q

what is “judgement”

A
  • the behavioural manifestation of insight
  • the process one uses to reach a decision or take action
  • ability to consider the pros and cons of decisions/choices
  • “poor judgement” may be demonstrated by impulsivity, engaging in actions with damaging consequences
22
Q

if someone knows they have an addiction that is negatively affecting their life but they continue to use drugs every day they have what kind of insight / judgement?

A

good insight but poor judgement

23
Q

what is included under “risk assessment” (self)

A
  • risk assessment to themselves: self harm or suicide (assess for both)
  • considers suicidal thoughts, plan, intent, means, impulsivity, risk and protective factors
  • inform level of risk (low, moderate, high)
24
Q

what are examples of suicide risk factors

A
  • age
  • sex (women more likely to try, men more likely to follow thru)
  • hx of psych disorder
  • current psych diagnosis
  • characteristic symptoms e.g., hopelessness, depression, guilt etc.
  • previous hx of suicidal behaviour
  • hx of abuse/trauma
  • substance use
  • situational risk factors/life stressors
  • family hx of suicide & psych disorders
  • living alone
  • social relationship problems
  • access to lethal means
    -physical health issues
25
Q

what are examples of suicide protective factors (individual & work)

A
  • individual factors = strong sense of competence, & purpose, effective interpersonal skills, problem solving skills, adaptive coping skills, self understanding, optimistic outlooks, religious affiliation

-work factors = sense of accomplishment, positive peer support, supportive work environment, core values, access to employee assistance programs

26
Q

what are examples of suicide protective factors (family & community)

A
  • family = sense of responsibility to family, relationships characterized by warmth and belonging
  • community = opportunities to participate, affordable accessible resources, hope for future, community self determination and solidarity
27
Q

what are the suicide levels of risk

A

non-existent, mild, moderate, high, imminent

28
Q

what is included under “risk assessment” (others)

A
  • thoughts of harming or killing others
  • plan/intent to harm others
  • means to harm others
  • hx of violence
  • substance abuse
  • psychotic processes

Sem 1 Concepts Exam (10 decks)

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