MSE- Lecture .pdf
- 1. Mental Status Examination (MSE) •most important diagnostic tool a psychiatrist has to obtain information to make an accurate diagnosis.
- 2. Appearance • Record the patient's sex, age (apparent or stated), race, and ethnic background. • Document the patient's nutritional status by observing the patient's current body weight and appearance.
- 3. Attitude toward the examiner • Record the patient's facial expressions and attitude toward the examiner. Note whether the patient appeared interested during the interview or, perhaps, if the patient appeared bored. • Record whether the patient is hostile and defensive or friendly and cooperative
- 4. Mood • The mood of the patient is defined as "sustained emotion that the patient is experiencing." Ask questions such as "How do you feel most days?" to trigger a response. Find More free PowerPoint templates on: http://www.leawo.com/free-powerpoint-templates/
- 5. • Helpful answers include those that specifically describe the patient's mood, such as "depressed," "anxious," "good," and "tired
- 6. Affect • A patient's affect is defined in the following terms: expansive (contagious), euthymic (normal), constricted (limited variation), blunted (minimal variation), and flat (no variation)
- 7. Speech • Document information on all aspects of the patient's speech, including quality, quantity, rate, and volume of speech during the interview
- 8. Thought process • . The process of thoughts can be described with the following terms: looseness of association (irrelevance), flight of ideas (change topics), racing (rapid thoughts), tangential (departure from topic with no return), circumstantial (being vague, ie, "beating around the bush")
- 9. • word salad (nonsensical responses, ie, jabberwocky), derailment (extreme irrelevance), neologism (creating new words), clanging (rhyming words), punning (talking in riddles), thought blocking (speech is halted), and poverty (limited content).
- 10. Thought content • To determine whether or not a patient is experiencing hallucinations, ask some of the following questions. • "Do you hear voices when no one else is around?" "Can you see things that no one else can see?“ • "Do you have other unexplained sensations such as smells, sounds, or feelings?"
- 11. Aspects of thought content are as follows • Obsession and compulsions: Ask the following questions to determine if a patient has any obsessions or compulsions. "Are you afraid of dirt?" "Do you wash your hands often or count things over and over?" “
- 12. • Phobias: Determine if patients have any fears that cause them to avoid certain situations. The following are some possible questions to ask. "Do you have any fears, including fear of animals, needles, heights, snakes, public speaking, or crowds?"
- 13. Insight • Assess the patients' understanding of the illness. To assess patients' insight to their illness, the interviewer may ask patients if they need help or if they believe their feelings or conditions are normal. A patient's attitude toward the clinician and the illness plays an important part to developing insight into their condition and overall prognosis.
- 14. Judgment • Estimate the patient's judgment based on the history or on an imaginary scenario. To elicit responses that evaluate a patient's judgment adequately, ask the following question. "What would you do if you smelled smoke in a crowded theater?" (good response is "call 911" or "get help"; poor response is "do nothing" or "light a cigarette").
- 15. Impulsivity • Estimate the degree of the patient's impulse control. Ask the patient about doing things without thinking or planning. Ask about hobbies such as coin collecting, golf, skydiving, or rock climbing
- 16. Reliability • Estimate the patient's reliability. Determine if the patient seems reliable, unreliable, or if it is difficult to determine. This determination requires collateral information of an accurate assessment, diagnosis, and treatment.