MENTAL STATUS EXAMINATION

NISHMA.V.MDEPT.APPLIED PSYCHOLOGY

• psychological equivalent of a physical exam.

• it includes both objective observations of the clinician and subjective descriptions given by the patient.

Components

• Assesses general quality of:

– amnestic functions

– cognitive processing and intellectual functions

– form and content of thought

– nature, expression, and appropriateness of affect

– adaptive and maladaptive behaviors

– Symptoms of psychopathology

What an MSE isn’t

• An intelligence test

• A detailed memory test

• A fully precise measure of cognition, affect, and behavior

Technique

• Direct

• Indirect

Major Components

1. Appearance

2. Motor

3. Speech

4. mood

5. Affect

6. Thought Process

7. Thought Content

8. Perception

9. Cognitive impairments

1)Appearance

Domains:• Appearance in relation to age

• Accessibility

• Body Build

• Clothing

• Cosmetics

• Hygiene and grooming

• Odor

• Facial expression

• Eye Contact

• Rapport with the therapist

It is just as straightforward as it seems

examples

• Mania

• Depression

• Chronic Schizophrenia, dementia, alcohol/drug de-addiction

• Anxiety

• Parkinson disease

2)Motor activity

• Psychomotor activity

• Movements

• Apparent restlessness

• Difficulty in initiation of movements

• Waxy flexibility

• negativism

3) SPEECH DISORDERS OF SPEECH

• Aphonia

• Slow speech

• Fast speech

• Pressure of speech

• Poverty of speech

• Poverty of content of speech

Rate

low

Volume

Amount

Tone

Coherence

relevance

4) Mood

– Euthymic (normal)

– Euphoric (elated)

– Dysphoric (sad)Mood- the subjectivestate of a person orhow the person“feels”

5) Affect:How do they appear to you?

• Stability

• Range

• Appropriateness

• Intensity

6) Thought process

• Circumstantiality

• Tangential

• Thought blocking

• Perseveration

• neologism

THOUGHT POSSESSION

•Thought echo•Thought insertion•Thought withdrawal•Thought broadcasting

7)Thought content

Refers to the themes that occupy the patients thoguts and perceptual disturbances

• Delusions :

(control,somatic, erotomanic)

• Ideas of reference

• Obessions

• Preoccupation with suicidal ideas

8)perception

• Hallucinations

• Illusions

• Depersonalization

• Derealisation

9)Cognitive functioning

• Orientation

• Memory

• Abstraction

• Intelligence or general information

• Judgment

• Insight

Drawbacks

– It does not indicate competence, because Pts. who score well may have difficulty with basic activities of daily living

– They are subject to interpretive bias and experience of the interviewer

– They have a fairly significant false-negative rate, esp. in pts. with right hemisphere lesions

– Demographics and culture: Age (>60), education (<9th

grade), limited cultural experiences, and low socioeconomic status limit usefulness

– Screening questionnaires are less sensitive to cognitive impairments

– with young children and others with limited language such as people with intellectual impairement.

• http://en.wikipedia.org/wiki/Mental_status_examination

• http://www.ncbi.nlm.nih.gov/books/NBK320/• http://www.slideshare.net/drjayeshpatidar/ment

al-status-examination-20852197• file:///M:/MSc/thrd%20sem/therpy/mse.pdf• http://www.testandcalc.com/richard/resources/T

eaching_Resource_Mental_Status_Examination.pdf

• http://psychclerk.bsd.uchicago.edu/mse.pdf

Thanks…