Mental State Examination Flashcards
Mental State Examination headings
- Appearance
- Behaviour
- Speech
- Mood/thought form and content (including any other thoughts of self harm)
- Suicidal or homicidal ideation
- Insight
- Cognitive Functioning (MSQ)
Mental State Examination
Appearance
- Height/Build
- Clothing - appropriate/inappropriate, kempt, bizarre
- Personal hygiene - clean/unshaven
- Make up, jewellery, accessories
Mental State Examination
Behaviour
- Greeting
- Non-verbal cues
- Gesturing - normal, expansive, bizarre
- Abnormal movements - tremor, choreoathetoid movements, posturing, akathisia
- Co-operative, rapport
Mental State Examination
Mood
- Eye contact
- Affect - objective manifestation of mood at i/v
- Mood rating - subjective and objective; rate out of 10
- Psychomotor function - regarded, agitated
Mental State Examination
Speech
- Spontaneity
- Volume - loud, quiet, poverty
- Rate - pressured, slowed
- Rhythm - rhyming and punning
- Tone - monotonous, lilting
- Dysarthria
- Dysphasia - expressive/receptive
Mental State Examination
Abnormal Thoughts
- Phobias
- Obsessions
- Flight of ideas
- Formal thought disorder - broadcast, echo, insertion, block, withdrawal
- Knight’s move, derailment, loosening
Mental State Examination
Abnormal Beliefs
- Preoccupations
- Over valued ideas
- Delusional beleifs - fixed, false belief out of cultural context
Mental State Examination
Abnormal percepts
- Illusions
- Hallucinations - pseudo, true
- Many domains - auditory, visual, somatic/tactile, olfactory & gustatory
Mental State Examination
Suicide/Homicide
- Must always ask about suicidal thoughts
- Ideation
- Intent
- Plans - vague, detailed, specific, already in motion
- Also homicidal risk
Mental State Examination
Insight
Refers to the ability of a patient to understand that they have a mental health problem
“What do you think the cause of the problem is”
“Do you think you have a problem at the moment”
“Do you feel you need help with your problem?”
Mental State Examination
Cognitive Function
- Orientation - time, place, person
- Attention/concentration - throughout interview
- Short term memory - 3 objects; name and address
- Long term memory - personal history
- Can also do a formal assessment: MMSE etc
Mental State Examination
How could a formal assessment of cognition be achieved?
- MSQ
- MMSE
- MOCA
- FAS
Mental State Examination
How would you explore psychotic symptoms - beliefs/thoughts
- “Has anything particular been playing on your mind?”
- “Have you noticed any change in your thoughts?”
- “Has anyone interfered with your thoughts?”
- “Does anyone else have access to your thoughts?”
- “Do you know why this is happening?”
