2. • psychological equivalent of a physical exam.
• it includes both objective observations of the
clinician and subjective descriptions given by
the patient.
3.
4. Components
• Assesses general quality of:
– amnestic functions
– cognitive processing and intellectual functions
– form and content of thought
– nature, expression, and appropriateness of affect
– adaptive and maladaptive behaviors
– Symptoms of psychopathology
5. What an MSE isn’t
• An intelligence test
• A detailed memory test
• A fully precise measure of cognition, affect,
and behavior
7. Major Components
1. Appearance
2. Motor
3. Speech
4. mood
5. Affect
6. Thought Process
7. Thought Content
8. Perception
9. Cognitive impairments
8. 1)Appearance
Domains:
• Appearance in relation to age
• Accessibility
• Body Build
• Clothing
• Cosmetics
• Hygiene and grooming
• Odor
• Facial expression
• Eye Contact
• Rapport with the therapist
It is just as
straightforward as it
seems
11. 3) SPEECH DISORDERS OF SPEECH
• Aphonia
• Slow speech
• Fast speech
• Pressure of speech
• Poverty of speech
• Poverty of content of
speech
Rate
low
Volume
Amount
Tone
Coherence
relevance
12. 4) Mood
– Euthymic (normal)
– Euphoric (elated)
– Dysphoric (sad)
Mood- the subjective
state of a person or
how the person
“feels”
13. 5) Affect:
How do they appear to you?
• Stability
• Range
• Appropriateness
• Intensity
14. 6) Thought process
• Circumstantiality
• Tangential
• Thought blocking
• Perseveration
• neologism
THOUGHT POSSESSION
•Thought echo
•Thought insertion
•Thought withdrawal
•Thought broadcasting
15. 7)Thought content
Refers to the themes that occupy the patients
thoguts and perceptual disturbances
• Delusions :
(control,somatic, erotomanic)
• Ideas of reference
• Obessions
• Preoccupation with suicidal ideas
17. 9)Cognitive functioning
• Orientation
• Memory
• Abstraction
• Intelligence or general information
• Judgment
• Insight
18. Drawbacks
– It does not indicate competence, because Pts. who score
well may have difficulty with basic activities of daily living
– They are subject to interpretive bias and experience of the
interviewer
– They have a fairly significant false-negative rate, esp. in
pts. with right hemisphere lesions
– Demographics and culture: Age (>60), education (<9th
grade), limited cultural experiences, and low
socioeconomic status limit usefulness
– Screening questionnaires are less sensitive to cognitive
impairments
– with young children and others with limited language such
as people with intellectual impairement.
The mental status examination (MSE) is the psychological equivant of a physical exam that describes the mental state and behavior of the person being seen.it includes both objective observations of the clinician and subjective descriptions given by the patient.
The MSE derives from an approach to psychiatry known as descriptive psychopathology[4] or descriptive phenomenology[5] which developed from the work of the philosopher and psychiatrist Karl Jaspers.[6] From Jaspers' perspective it was assumed that the only way to comprehend a patient's experience is through his or her own description (through an approach of empathic and non-theoretical enquiry), as distinct from an interpretive or psychoanalytic
The data are collected through a combination of direct and indirect means: unstructured observation while obtaining the biographical and social information, focused questions about current symptoms, and formalised psychological tests
]
There are potential problems when the MSE is applied in a cross-cultural context, when the clinician and patient are from different cultural backgrounds. For example, the patient's culture might have different norms for appearance, behavior and display of emotions. Culturally normative spiritual and religious beliefs need to be distinguished from delusions and hallucinations - these may seem similar to one who does not understand that they have different roots. Cognitive assessment must also take the patient's language and educational background into account. Clinician's racial bias is another potential confounder.
