MSE Flashcards
what are the components of MSE
appearance behaviour speech mood + affect thought perception cognition insight
describe what you would look for in appearance
age gender race clothing grooming / kemptness smell gait evidence of self harm, bruises posture involuntary movement - fidgeting, restless
describe what you would look for in behaviour
rapport eye contact overfamiliarity/social disinhibition withdrawn, psychomotor retardation fidgeting distracted inappropriate hand gestures
describe what you would look for in speech
rate volume tone amount delay pressure of speech poverty of speech
can be described as appropriate, minimal…
mood is objective/subjective
subjective
the patient tell you how they feel
use their own words
affect is objective/subjective
objective
observe how the patient is during the appointment
list the components of thought in MSE
thought control
thought forming
thought content + risk assessment
describe thought control
thought insertion, withdrawal and broadcasting
what is thought insertion
putting thoughts inside your head
what is thought withdrawal
taking thought out of your head
what is thought broadcasting
everyone walking down the streets can know your thoughts
disorders of thought forming
neologisms
flight of ideas
loosening of associations
disorders of thought content - give examples
delusions of: grandiose - inflated sense of worth paranoia persecutory - someone is out to get them guilt sin nihilism - death, perished organs disease reference - signs that have specific meaning to them perception religion
what is a delusion
false belief held in firm place despite evidence to the contrary
what do you assess in perception in MSE
hallucinations and illusions
what is a hallucination
sensory experience/perception without an external stimulus
in which modality do hallucinations occur
all sensory modalities auditory visual tactile gustatory olfactory
what kinds of auditory hallucinations can you get
2nd person - voice directly addresses the patient
3rd person - voices which discuss the patient
thought echo - patient experiences their own thoughts spoken/out loud
what is an illusion
misperception of a real stimulus
how can you assess cognition
4AT, MMSE
age, date, location
list months backwards
how can you assess insight
is the patient aware of their condition, symptoms and need for treatment to make them better
neologism
new made up word by the patient that makes sense to them
circumstantiality
go off topic but eventually return to initial topic
tangentiality
digress and never return to main topic
clanging and punning
changing topic based on sounds and meaning of words
loosening of association
unrelated jumping of ideas
Knight’s move thinking
change topic based on words/ideas from previous sentence
word salad
random words thrown together in a sentence
flight of ideas
rapidly shifting thoughts
poverty of speech
reduced / minimal / none
pressure of speech
speaking rapidly
describe examples of affect and cases where they are seen
reactive / congruent - changes according to topic: normal
flattened - unreactive regardless of topic: depression
blunted - ‘so what’ attitude: psychosis
elevated / incongruent - elated: mania
