Mental State Examination

Question 1

what is the difference between the information in a history and an MSE?

Answer 1

history = patients account 
MSE = your observations

Question 2

what eight things are assessed in an MSE?

Answer 2

appearance 
behaviour 
speech 
affect + mood 
thoughts 
perception 
cognition 
insight

Question 3

what kind of things are you looking at in the patients appearance as part of the MSE?

Answer 3

body habitus
grooming 
attire 
posture 
injuries

Question 4

what kind of things are you assessing when it comes to speech in an MSE?

Answer 4

rate
amount
tone
volume

Question 5

what is a patients mood?

Answer 5

how they feel in the moment

Question 6

what is a patients affect?

Answer 6

your observation of how the patient appears and reacts throughout the interview

Question 7

name five ways you could describe a patients affect

Answer 7

reactive (normal)
unreactive (no change) 
incongruent (inappropriate
blunted (no extremes)
flattened (low baseline)

Question 8

what three things need to be assessed when checking cognitive function?

Answer 8

orientation in time, place and person
concentration
memory

Question 9

what is autobiographical memory?

Answer 9

memory of personal events

Question 10

what is retrograde memory?

Answer 10

memory of past events e.g. historical events

Question 11

what is anterograde memory?

Answer 11

memory of new events e.g. remembering a list of objects

Question 12

what three types of memory can be assessed as part of a cognitive assessment?

Answer 12

autobiographical
retrograde
anterograde

Question 13

what are you assessing when looking at the patients insight in an MSE?

Answer 13

do the know they are unwell? and why?and do they accept that they need treatment?

Question 14

what is a hallucination?

Answer 14

a perception which occurs in the absence of an external stimulus

Question 15

what are the three types of auditory hallucinations?

Answer 15

second person
third person
thought echo

Question 16

what is a second person auditory hallucination?

Answer 16

a voice that is directly addressing the patient

Question 17

what is a third person auditory hallucination?

Answer 17

a voice which discusses the patient or provides a running commentary on their actions

Question 18

what is a thought echo auditory hallucination?

Answer 18

a voice that repeats the patients own thoughts out loud

Question 19

what are visual hallucinations often associated with?

Answer 19

altered consciousness

Question 20

what are the two groups of visual hallucinations?

Answer 20

simple - flashes of light etc.

complex - faces, figures etc.

Question 21

what is the passivity phenomena?

Answer 21

when behaviour is experienced as being controlled by someone else rather than by the individual

Question 22

what abnormalities are often seen in patients with passivity phenomena, and what are these areas normally responsible for?

Answer 22

parietal and cingulate cortex abnormalities on PET

involved in interpretation of sensory information

Question 23

what is a thought disorder?

Answer 23

when there is a problem with the formation of thoughts

Question 24

how is a thought disorder identified?

Answer 24

through evidence found in the patients speech/writing

Question 25

name three thought disorders

Answer 25

flight of ideas loosening of associations neologism

Question 26

what happens in flight of ideas?

Answer 26

the patient jumps from topic to topic with recognisable but inappropriate links

Question 27

what happens in loosening of associations?

Answer 27

patients speaks illogically and vaguely so it is difficult to follow and no information is really given

Question 28

what is knight's move thinking?

Answer 28

when there are jumps between topics that have no logical connection

Question 29

what is neologism?

Answer 29

an abnormality of speech in which the patient either makes up new words or uses existing ones in bizarre ways

Question 30

what is a delusion?

Answer 30

a false belief or a belief held on false grounds will be firmly held no matter what

Question 31

what needs to be considered when a patient presents with a delusion?

Answer 31

if this is having a functional impact on their lives

Question 32

what themes are seen in delusions in depression?

Answer 32

``` disease nihilism poverty sin guilt ```

Question 33

what themes are seen in delusions in schizophrenia?

Answer 33

control persecution religion love

Question 34

what themes are seen in delusions in mania?

Answer 34

grandiosity persecution religion