MSE

Question 1

MSE

MSE Steps

Answer 1

ASEPTIC
Appearance & Behaviour
Speech
Emotions - Mood & Affect
Perception
Thought
Insight & Judgement
Cognition

Question 2

MSE

Appearance

Answer 2

Clothing
- Disheveled can indicate disorganised in schizophrenia or uncaring in depression
- Bright or revealing could be mania.
Hygiene
- Hair, nails and teeth.

Question 3

MSE

Behaviour

Answer 3

Eye Contact
- Non-specific indicator of something being wrong.
Posture
- Slumped might be a depression
- Standing may be anxious.
Movements
- Restlessness or slow movement may be present.
- Extrapyramidal side effects (rolling tremor of hand, spasm of neck).

Question 4

MSE

Speech

Answer 4

Rate
- Fast uninterruptible speech may indicate mania or anxiety
- Slow in depression.
Prosody
- Musicality of speech.
- Loss of this may indicate depression, schizophrenia or drug side effects.

Question 5

MSE

Affect

Answer 5

Quality
- The type of emotion (happy, sad, perplexed).
Intensity
- A blunted affect means there feels like a pane of glass between you and the patient. A classical sign of chronic schizophrenia
Range
- The number of emotions in the interview.
Mobility
- How quickly emotions accelerate.
Reactivity
- Does the affect change depending on what you say? If not then this could be the mark of chronic schizophrenia
Congruence
- The affect does fit the thought, i.e. laughing at loss

Question 6

MSE

Thought

Answer 6

Stream
- The speed at which thoughts come out.
Form
- Description of how thoughts are joined.
- Tangentiality, derailment, flight of ideas, circumstantiality & perseveration
Content
- Themes and pathology. Themes are the essence of what someone is saying. Pathology includes delusions.

Question 7

MSE

Form types

Answer 7

Thought description
Tangentiality
- The point is gradually lost when the patient speaks.
Derailment
- More severe form of tangentiality.
Flight of ideas
- Each sentence is linked but the point rapidly shifts, characteristic of mania
Circumstantiality
- Over-inclusiveness, a sign of anxiety.
Perseveration
- Patient keeps returning to the same theme

Question 8

MSE

Perception

Answer 8

Hallucinations

- Any of the five sensors

Question 9

MSE

Cognition

Answer 9

Consciousness
- delirium
Attention
Memory
- dementia
Orientation
 - delirium
Intelligence
Executive function
- Frontal lobe deficits (in chronic schizophrenia)

Question 10

MSE

Insight

Answer 10

Does the patient know what is wrong and how it affects them?

Question 11

MSE

Judgement

Answer 11

How capable is the patient at making decisions?