Mini Mental Status Examination

Mini Mental Status ExaminationConde, Graciella Marie D.S.What is Mini Mental Status Examination or MMSE?

It is a method of organizing and evaluating clinical observations during an interview.

It is very common to medical settings.

It usually results in one medium-length paragraph describing the clients mental status.

What is Mini Mental Status Examination or MMSE?

It is an important part of the clinical assessment process in the psychiatric practice.

It is commonly used in medicine to screen for dementia.

What is Mini Mental Status Examination or MMSE?

It is a structured way of observing and describing patients current state of mind under the domains of:

appearance , attitude , behavior , mood & affect , speech, thought process, thought content , perception , cognition insight and judgment.

What are the purposes of MSE?

It is a series of questions and observations that provide a snapshot of a clients current mental, cognitive, and behavioral condition.

To obtain a comprehensive cross-sectional description of the patients mental state which, when combined with the biographical and historical information of psychiatric history.

5What are the purposes of MSE?It also allows the clinician to make an accurate diagnosis and formulation, which are required for coherent treatment planning.

It is important neurological and psychiatric evaluation.

General DescriptionIt includes the age, height, weight, manner of dress and grooming.

what the patient is doing?

what the patient is wearing?

how the patient looks?

Appearance describe the body type-weight, height & age; posture- if relaxed, rigid tense etc. clothes-neat, untidy, dirty etc. grooming, hair & nails.

Appearance For Example:

dirty clothes might suggest schizophrenia or depression.

if the patient appears much older than his age this can suggest chronic poor self care.

Appearancebody modifications or clothing not typical of the patients gender, might give clues to personality.

Observation of physical appearance might include the physical features like, alcoholism or drug abuse, such as signs of malnutrition nicotine stains and dental erosion.

AppearanceNote: The signs of anxiety should be noted; moist hands, perspiring forehead, tense posture and wide eyes.Behavior or Psychomotor Activitygait describes the manner of walking or moving on foot.

agitation violent reaction

agility being mentally quick & resourceful

Behavior or Psychomotor Activitytics-spasmodic it is a loss of muscle control.

wringing of hands-twitches & squeezing of hands.

psychomotor retardation slowing down of body movements should be noted.

Behavior or Psychomotor ActivityMannerisms it describes a habitual gesture or way of speaking.

Example: >Psychomotor retardation might indicate depression or medical condition such as Parkinsons disease.

Behavior or Psychomotor ActivityGestureExample: She is always smiling whenever ask questions about herself.

Examiner would also comment on eye movements >repeatedly glancing to one side can suggest that the patient is experiencing hallucinations.

Behavior or Psychomotor ActivityThe quality of eye contact which can provide clues to the patients emotional state.

Note: Physical manifestations or signs, any aimless or without direction, purposely activity or intentionally

(e.g. she had purposely made it difficult)

Attitude toward Examiner

it refers to the patients approach to the interview process and the interaction with the examiner.

record the patients facial expression

note whether the patient appeared interested during interview or perhaps if the patient appeared bored.

Attitude toward Examiner

record whether the patient is hostile and defensive or friendly or cooperative.

note whether the patient is comfortable or uncomfortable with the interview.

Mood and Affect

Mood of the patient defined as sustained emotion that the patient is experiencing.

You can ask question such as How do you feel most days?

It should also include any other adjectives to describeMood and Affect

Note: > Labile fluctuates or alertness rapidly between extremes

>(e.g. laughing loudly & expansive one moment, or tearful and despairing next)

Mood and AffectAffect describes the apparent emotion conveyed by persons non verbal behavior such as anxious & sad.

Note: >Patients difficulty in initiating, sustaining or terminating an emotional response.

Speech

Documents information on all aspects of the patients speech, including the quality, quantity, rate, and volume of speech during the interview.

Paying attention to patients responses to determine how to rate their speech is important.

SpeechSome things to keep in mind during the interview are whether patients raise their voice when responding, whether the replies to the questions are one word answers or elaborative, and how fast or slow they are speaking.

Note: Dysprosody unusual rhythms; also note accent.