Mental Status Exam Flashcards
Name all 11 areas of MSE
- General Description
- Emotional State
- Speech
- Thought processing/stream of thought
- Thought content
- Risk assessment
- Perception
- Cognitive state
- Insight
- Volition
- Physical functioning
General Description Categories
- Appearance
- Behaviour and motor activity
- Attitude during the interview
Appearance
General description
- Patient’s dress and grooming
- inconsistent with season ro time of day
- meticulous
- level of hygiene
- unique application of clothing or make up - Features of physical appearance
- Apparent age = chronological age
- Approximate weight and height
- Body modification
- Emaciation (abnormally weak or thin) - Facial expression
- Relationship to expressed mood or thought content
- Wincing in pain - Eye contact
- Avoidance
- Staring
Behaviour and Motor Activity
General description - describe the non-verbal behaviour during the interview. Details of the following ocl be used to generate a mental image of the person during an interview • Mannerisms • Tics • Gestures • Tremors • Restlessness • Slowed • Automatic behavior • Doubled over to relieve pain fully ambulatory • Echopraxia • Abnormal breathing patterns • Unsteady gait • Walks with assistance • Confined to a wheelchair • Bedridden
Attitude during the Interview
General description - you should describe the person’s prevailing attitude toward you, and the experience of being interviewed. Use adjectives in this section
Any changes in attitude during interview should be documented and whether they are gradual or borough on my topics. Can report on rapport
Towards the examination • Neutral • Fearful • Perplexed • Hostile • Evasive • Sarcastic • Ingratiating • Dramatic • Seductive • Completely unresponsive
Toward the examiner • Belligerent • Sarcastic • Dependent • Demanding • Irritable • Pleasant • Flirtatious
Emotional State Categories
- Mood
- Affect
- Anxiety
Mood
Emotional state - how the person feels. Subjective
May use words like
‘irritable, panicky, terrified, angry, enraged, elated, euphoric, empty, guilty, hopeless, helpless, futile, and self-contemptuous’.
Affect
Emotional state - observation and assessment of their prevailing mood or moods
Includes range, change in pattern, intensity, and appropriateness
- Grandiose
- Agitated
- Flat
- Labile
- Despondent
- Lonely
- Irritable
- Bewildered
- Suspicious
Anxiety
Emotional state - a description of the person’s fears, worries and anxieties are documented. Generalized/non-specific or related to certain things (phobias)
Speech
- Volume - loud/quiet
- Rate - pressured, slowed, appropriate
- Quality - fluctuations in tone
- Comprehension - understands instructions, misinterpretations
- Clarity - understandable
Thought Process / Stream of Thought
Comprehensive assessment of thought process needs speech and language. Describe how the patient’s thinking flows from topic to topic - the way they think
- Rate of thought
- Does the patient appear to think rapidly slowly - paucity of idea an overabundance of ideas - Flow of ideas
- Connectedness or organization of the thoughts
- Are connections logical?
- Relevant or irrelevant
- Tangentially
- Circumstantiality
- Flight of ideas
- Loosening of associations
- Echolalia
- Word salad
- Neologisms
- Perseveration
- Form of thought
- Preoccupied and hesitant
- Do the responses answer the questions?
- Blocking
- Paucity of ideas
- Impoverished
- Overly inclusive
- Non-sequiturs
- Loosening of associations
Thought Content
Describe the person’s prevalent thoughts and pre-occupations “main worries”
- Phobias
- Obsessions
- Compulsions
- Delusions
- Physical concerns
- Anti-social urges
- Ideas of reference
- Ideas of influence
- Thought insertion
- Thought broadcasting
- Thought withdrawal
Risk Assessment
The presence or absence of suicidal and homicidal ideation, including severity, must be specifically documented.
- Suicidal or homicidal ideation, intent and plan
- Duration, frequency, intensity of these thoughts
- Control of thoughts
- Desire and intent to act
- Existence and nature of suicidal or homicidal plan - Delusional thought content that impact their person’s life or behaviour
- The content of auditory hallucinations
- Ability to control them
- Effect on quality of life
- Impact on person’s behavior
- Likely actions in event of increasing intensity - The presence of command hallucinations
- The ability of the individual to control them
- Impact on behaviour
- Likely actions in event of increasing intensity
Perception
The content, mode of onset, the source, vividness, reality of experience. The disturbances may be described by the patient
- Hallucinations - False sensory perceptions in the absence of an external stimulus.
- Ilusion - Are misinterpretations of actual external events and they may involve the same sensory modalities.
- Misidentification - Occurs when the individual falsely believes they recognize a stranger
- Depersonalization - a sense of unreality or estrangement
Cognitive State
The level and awareness of alertness and the person’s ability to carry out the tests related to general knowledge, memory, attention and concentration.
- Consciousness
- Describes the person’s level of awareness - alert, drowsy, delirious - Orientation - time, place, person
- Concentration and attention - how easily the person’s attention is aroused and how easily it’s diverted
- General Information - being able to name current prime minister and political party, capital city etc
- Intellectual Ability - notice if there’s a wide disparity between his functioning as ascertained from history
- Memory
a. Remote memory - important events from childhood
b. Recent memory - what did you have for breakfast
c. Immediate retention and recall - repeat six figures after the examiner has listen them - Judgement - how do you think your hallucinations should be handled? What would you do in this certain situation
- Abstract thinking
- The ability to make generalizations - Abstract - apples and oragnes are both fruit
- Concrete - they are both round
- Bizzare - i eat them and turn into pumpkins
