1 - Mental State Examination Flashcards
(27 cards)
What are the 7 components of the MSE?
1 - Appearance and behaviour 2 - Speech 3 - Emotion: mood and affect 4 - Perception 5 - Thought 6 - Insight 7 - Cognition
List some things to note when assessing appearance and behaviour:
- Clothing
- Self-care
- Body language
- Eye-contact
- Psychomotor retardation
- EPSE from antipsychotics
List some things to note when assessing speech:
- Rate
- Rhythm
- Volume
- Content
- Quantity
- Tone
- Dysarthria
- Dysphasia
How would you report a patients emotion in the MSE?
Mood:
- Objectively (your impression)
- Subjectively (their impression)
Affect:
- Blunted/flat
- Appropriate/inappropriate/incongruous
- Stable/labile
If a patient reports hallucinations, where in the MSE would you document this?
Perception
Name the types of hallucinations:
- Visual
- Auditory (2nd/3rd person, running commentary)
- Olfactory
- Gustatory
- Somatic
What are the common causes of visual hallucinations?
- Substance misuse
- Organic brain disease
- Hyperactive delirium
- Migraines
What are the common causes of auditory hallucinations?
- schizophrenia
- severe depression + psychosis
- mania + psychosis
- middle/inner ear disease
- auditory nerve disease
- delirium
- alcohol
- substance misuse
What is meant by depersonalisation?
Feeling of detachment from normal sense of self
What is meant by derealisation?
Feeling of unreality ie life is a stage set, Truman show
What are the 3 components of thought?
1) Thought content
2) Thought form
3) Thought stream
Name some thoughts which are classified as abnormal thought content:
- Delusions
- Obsessional thoughts
- Preoccupations/overvalued ideas
Define delusion:
Fixed, false beliefs which are firmly held despite evidence to the contrary, and go against the individual’s normal social and cultural belief system
Name some types of delusions:
- Grandiose
- Persecutory
- Nihilistic
- Hypochondriacal
- Guilt
Define obsessional thoughts:
Distressing thoughts which enter the mind despite the patient’s effort to resist them
Define preoccupations/overvalued ideas:
Strongly held beliefs which are important in 4 disorders: depressive, anxiety, eating, sexual. They can be put out of the mind with effort.
What types of abnormal thought form are often seen in schizophrenia?
- Loosening of association ie derailment of thought, word salad, tangential thinking
- Neologisms
What type of abnormal thought form is often seen in dementia?
Perseveration
= uncontrollable and inappropriate repetition of words/gestures/phrase
Name some types of ‘loosening of association’ of thought form:
- Tangential thinking
- Word salad
- Derailment of thought (Knight’s move)
Name some types of abnormal thought form:
- Loosening of association
- Circumstantiality
- Neologisms
- Perseveration
What is circumstantiality?
A disorder of thought form, where thinking is slow with unnecessary details/digressions.
Seen in obsessional personalities and learning disabilities.
What is a neologism?
Words and phrases devised by the patient. A disorder of thought form. Seen in autism and schizophrenia.
What disorders of thought stream are sometimes seen in mania?
- Flight of ideas
- Pressured thought
Which disorder of thought stream is seen in depressive illnesses?
Retardation - slow thinking
