Scribd
Upload
80 views9 pages

1.MSE Part 1

The mental status exam provides information about a patient's mental state at a specific time. It assesses appearance, behavior, speech, mood, affect, thought processes, perceptual disturbances, cognition, insight, and judgment. Key areas examined include physical appearance, attitude, speech patterns, facial expressions, posture, thought form and content, and possession of thoughts. The exam helps evaluate symptoms of various mental health conditions.

Uploaded by

sisqa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
80 views9 pages

1.MSE Part 1

The mental status exam provides information about a patient's mental state at a specific time. It assesses appearance, behavior, speech, mood, affect, thought processes, perceptual disturbances, cognition, insight, and judgment. Key areas examined include physical appearance, attitude, speech patterns, facial expressions, posture, thought form and content, and possession of thoughts. The exam helps evaluate symptoms of various mental health conditions.

Uploaded by

sisqa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 9

MENTAL

PART 1

STATUS
EXAMINATI
ON
131847
MSE
 The mental status exam tells only about the mental status at that moment; it can change
every hour or every day
 Usually conducted after the history taking
 Headings :
1. Appearance & Behaviour
2. Speech
3. Mood & Affect
4. Thought
5. Perceptual Disturbances
6. Cognition
7. Insight
8. Judgment/Impulse Control
APPEARANCE/BEHAVIOUR
B) Attitude towards examiner
A ) Physical appearance:  Cooperative/uncooperative
 Gender  Seductive
 Attentiveness
 Age (looks older/younger than stated age)
 Appears interested / disinterested
 Type of clothing  Hostile
 Hygiene ( smelling of alcohol, urine, feces)  Guarded
 Self - neglect
C) Comprehension
 Recent weight loss :  Intact / impaired (partial / fully)
 Physical disorder (cancer, hyperthyroidism),
 Psychological disorder (anorexia nervosa,
depressive disorder) D) Social manner & behavior
 Social problem ( financial difficulty,  Eye contact
homelessness)  Looks comfortable
 Tattoos or body piercings (some obsession)  Eg :
 Manic pt - unduly familiar or disinhibited
 Pupil size: drug intoxication/withdrawal.
 Dementia pt - behave as if they were somewhere
 Bruises in hidden areas: ↑ suspicion for abuse. other than in a medical interview.
 Needle marks/tracks: drug use.  Schizophrenia pt - withdrawn and preoccupied
 Antisocial personality disorder - behave aggressively.
 Superficial cuts on arms
D. Facial appearance E. Posture and movement
 provides information about mood. Posture :
 Eg :  Eg :
 In depression  Depressed - patient sits with hunched shoulders, with head
 corners of the mouth are turned down, and gaze inclined downwards.
 there are vertical furrows on the brow.  Anxious patient - sit on the edge of their chair, sits upright
w head erect and hands gripping chair.
 Anxious patients have
 Manic patients - overactive and restless.
 horizontal creases on the forehead
 widened palpebral fissures Movement
 dilated pupils.  manic pt - overactive, restless rapidly from place to place
and task to task.
 Parkinson syndrome (primary or caused by anti-
 Depressed pt - inactive and move slowly, rarely depressed
psychotic drug)
pt becomes completely immobile and mute (stupor)
 fixed ‘wooden’ expression.
 Anxious or agitated pt - restless and sometimes tremulous.
 Other abnormalities of movement include tardive
dyskinesia, tics & choreiform movements
SPEECH 3. Spontaneity (flow and rhythm of speech)
 Abnormalities in the flow of speech
 anxious, distracted patient, or one of low
1. Quantity intelligence.
 Depressed pt - speak less than usual (pause for  may be evidence of disturbances in the stream or
a long time before replying to questions, and form of thoughts.
then give short answers)  Pt w depression or intoxicated pt - may have a long
 Manic pt - speak more answer latency.
 Occasionally pt didn’t talk at all (mutism)  Pt w mania - answer promptly and often very quick

4. Volume & tone of speech


2. Rate
 Depressed pt speak quietly,
 Depressed pt - speak more slowly than usual
 manic pt speak loud may be heard far down the
(slow, sparse, and monotonous) corridor
 Manic pt - speaks faster ; pressured speech is
copious rapid speech which hard to interrupt. Difficulties with speaking
 Dysphasia
 dysarthria
MOOD & AFFECT
AFFECT
MOOD  How does pt appear to be feeling
 is the emotion that the patient tells you he  Affect is characterized in several ways:
feels, often in quotation  Type of affect/motion expressed : anger, sadness, euphoria,
 Asking pt in their own words “How are  Intensity/depth : happy, sad, normal, blunted (severely reduced) or flat(no
expressions).
you feeling?’ - Depression, angry, anxiety
 Range of emotions shown ; broad affect (normal), restricted/constricted
etc
affect.
 Constancy of mood
 Appropriateness
 fluctuate and varies from day to day or  Appropriate
hours  Inappropriate - Eg : laughing telling a story which is horrifying
 depending on the :  Consistency/lability of emotion (how quickly a person appears to shift
 internal circumstances (what the emotional states
 Sluggish
person thinking)
 Supple
 external circumstances (reminders
 Labile (eg : a patient who is laughing one second and crying the next)
of a failed relationship or of recent
exam success)
THOUGHTS
Form Flow/stream
 The patient’s form of thinking—how he or she uses language and puts
ideas together.  Increased / decreased /disturbance
 It does not comment on what the patient thinks, only how the patient  Pressure of thought - thoughts are
expresses his or her thoughts. usually rapid, abundant and varied.
Characteristic in mania
 Fantasy thinking - the connection may be meaningful but the  Poverty of thoughts - thoughts are
conclusion reached are unrealistic unusually slow, few and unvaried.
 Neologism – newly formed words/Made-up words by the patient. Severe depression or schizophrenia.
 Association disturbance  Blocking of thoughts - Should not be
 Looseness – No/lack logical connection from one thought to confused w sudden distractions. It is a
another – usually in schizophrenia complete emptying and blocking of
 Flight of ideas – a rapid shifting of ideas with only superficial mind. In schizophrenic pt.
associative connections between them usually accompanied by
rapid/pressured speech) - manic phase of bipolar disorder.,
 Clang associations: Word connections due to phonetics rather than
actual meaning. “My car is red. I’ve been in bed. It hurts my head.”
Content of thought Possession of thoughts
 Preoccupations - thoughts that recur frequently but  Normally subject experiences his thinking
can be put out of mind with will ; depression, anxiety as his own.
disorder, sexual disorders  Disorder of possession  he thinks that
 Morbid thoughts - particularly with specific illnesses ; his thoughts are no longer its own or no
more under control.
suicidality, depression, self critism, helplessness, low  Thought insertion ; ‘do u think that
self esteem) other people/force are putting their
 Delusions - a belief that is held firmly despite being thoughts in your mind/head against
your will?’
contradicted by reality or rational argument
 Thought broad casting ; ‘do you think
 Phobias: persistent, irrational fears.
that others can know your thoughts
 Obsessions: repetitive, intrusive thoughts. without u telling so?’
 Compulsions: repetitive behaviors (usually linked with  Thought withdrawal ; ‘do you think
obsessive thoughts). somebody/force is taking/snatching
your thoughts away against your will?’
REFERENCE

You might also like