MSE

Question 1

What are the different sections of the mental state examination?

Answer 1

• Appearance
• Behaviour
• Speech
• Mood and Affect
• Thought
• Perception
• Cognition
• Insight
• Judgement - risk to self/ others, neglact, vulnerability, misadventure

Question 2

How to assess appearance during a MSE

Answer 2

• General appearance - sex, height, weight, build etc
• Distinguishing features - self harm scars, IV track marks etc
• Personal hygeine
• Clothing - weather appropriateness
• Objects bought by the patient

Question 3

How to assess behaviour during MSE

Answer 3

• engagement and rapport
• eye contact
• facial expression
• body language
• psychomtor activity
• abnormal movements or postures

Question 4

How to asses speech during MSE

Answer 4

• rate - pressure of speech, slow speech
• quantity - minimal or excessive
• tone - monotonous, tremulous
• volume
• fluency and rhythm of speech - stammering, slurred speech

Question 5

How to assess mood and affect

Answer 5

• Mood represents a patient’s predominant subjective internal state
• Affect is what you observe - patient’s facial expression and overall demeanour

Question 6

How to assess thought during MSE

Answer 6

• Thought describes in terms of form, content and possession
• thought form - speed, flow, coherence,
• thought content - delusions, obsessions, compulsions, suicidal, homicidal thought
• thought possession - thought insertion, withdrawal, broadcasting

Question 7

How to assess perception during MSE

Answer 7

Abnormalities of perception include:

• hallucinations
• pseudo-hallucinations (patient is aware that they are not real)
• illusions
• depersonalisation
• derealisation (a sense that the world around them is not true reality)

Question 8

How to assess cognition during MSE

Answer 8

• are they orientated in space and time?
• attention span and concentration levels
• short-term memory
• can carry out MMSE, AMTS, ACE-II