Mental state examination Flashcards
(25 cards)
What is the MSE?
Objective assessment of the current episodes of illness
What features do you look for in an MSE?
Appearance + Behaviour Speech Mood Thoughts Perception Cognition Insight Risk
What are you looking for in someone’s appearance and behaviour?
Age, gender, ethnicity and occupation Dress and self-care Manner Posture and movement Rapport
What are you looking for in someone’s speech?
Rate Rhythm Tone Volume Pressure / Poverty Coherence
What is pressured speech?
When someone is talking very fast as if they are being pressured to release words
What is poverty of speech?
Lack of content, little speaking
What are you looking for in someone’s mood?
Subjective
Objective
Affect
What is affect?
How a patient presents in the consultation
What is an incongruant affect?
If the affect does not match
What is a reactive affect?
Describes an affect that varies appropriately to the scenario / situation - is normal
What is a labile affect?
Describes an affect that is very extreme, react more than they should to things
What are you looking for in someone’s thought?
Content
Preoccupations
Delusions
Form
What impacts thought content?
Thought insertion, withdrawal or broadcasting
How can you tell someone is preoccupied in thought?
Recurrent thoughts which the person is unable to put aside
- worries, overvalued ideas, obsessions, thoughts of harm
What are delusional thoughts?
Grandiose Persecutory Hypochondriacal Nihilistic Guilty Infidelity Amorous Control
What are the forms of thought?
Pressure Poverty Thought blocking Loosening of associations Knight's move Neologisms Perseveration circumstantial Derealisation
What is knight’s move thoughts?
When thoughts jump and have no clear link
What are you looking for in perception?
Hallucinations
Illusions
Depersonalisation
Derealisation
What are you looking for in cognition?
Orientation
Attention and Concentration
Memory
Grasp
What is Insight?
Does the patient consider themselves well and do they consider that they need their treatment?
What are you looking for in a patient’s risk?
Risk to themselves
Risk to others
From others
Ask about dependents !
How could a patient be a risk to themself?
Neglect
Deliberate self harm
Forgetful (leave things on)
How could a patient be at risk from others?
Abuse
Financial
How are there other ways to assess cognition?
Abbreviated mental test score
Mini mental state exam
Addenbrooke’s cognitive examination (ACE)
Frontal lobe testing
