A structured assessment of a patients mental & behavioral functioning . it can helps detect & track mental health & neurological conditions

1. MENTAL STATUS
EXAMINATION (MSE)

2. INTRODUCTION:
• The Mental Status examination is the part of the
clinical assessment that describes the sum total of
the examiner's observations and impressions of
the psychiatric patient at the time of the interview.
• Whereas the patient's history remains stable, the
patient's mental status can change from day to day
or hour to hour.

3. INVENTOR OF MSE:
Click icon t
MSE, is developed from
the work of the
philosopher and
psychiatrist Karl Jaspers.

4. DEFINITION:
The Mental Status Examination (MSE) is the
psychological equivalent 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
description given by the patient.

5. WHY DO WE DO IT?
• The MSE provides information for diagnosis and
assessment of disorder and response to treatment.
• A Mental Status Exam provides a snap shot at a
point in time.
• If another health care provider sees your patient it
allows them to determine if the patients status has
changed without previously seeing the patient.

6. COMPONENTS:
ABS; MATT Please Can I Judge?

7. GENERAL APPEARANCE:
• Level of grooming: (Tidy /Unkempt / Disheveled)
• Weight: (Over Weight / Under weight)
• Gait:
Spastic gait- Person drags his feet.
Scissor Gait- A person whose legs bend inward will often have a
scissor gait.
Steppage Gait- Toes point inwards.
Propulsive Gait- Person walks with head or neck pushed forward.

9. BEHAVIOUR:
• Level of consciousness: (Conscious / drowsy/stupor/
comatose)
• Psycho motor activity : ( Increased/Decreased/stable)
• Eye contact: (maintain/not maintain)
• Mannerism: (present/absent)
• Rapport: (spontaneous/difficult/not established)
• Gesture: (Normal/exaggerated/odd)
• Posture: (Normal/catatonic/stooped/stiff/guarded)
ATTITUDE
• Cooperative/Hostile/open/secretive/suspicious/apathetic

12. SPEECH AND LANGUAGE:
• Quantity:
(Talkative/spontaneous/expansive/paucity/poverty)
• Rate: (Fast/slow/pressured/normal)
• Volume: (Loud/soft/monotonous)
• Fluency & Rhythm: (slurred/clear/hesitant/good
articulation)
• Relevance: (Relevant/Irrelevant)

14. MOOD:
• A pervasive and sustained emotion that color
the patient’s perception of the world
subjectively experienced and reported by the
patient.
• Often placed in quotes since it is what the
patient tells you. Example-( Fantastic, elated,
depressed, anxious, sad, angry, irritable, good)

15. AFFECT:
The expression of emotions expressed by the patient and observed by the
others. It varies over the time in response to changing emotions.
• Type: Euthymic (normal mood), Dysphoric (depressed, irritable, angry),
Euphoric (elevated, elated), Anxious
• Range: Normal, Blunted or flat (no sign of affective expression,
monotonous voice), Labile (rapid variability in affective expression)
• Congruency: does it match with the mood (mood congruent vs mood
incongruent)
• Stability: stable vs. labile
• Appropriateness: Appropriate to situation or not appropriate to
situation.

17. THOUGHT:
A.Stream (flow of thought) : [normal/thought block/pressured
thought/retarded thinking (poverty of thought/flight of ideas/ mutism]
B. Thought form:
(not understandable/ambivalence/Circumstantial/Tangential)
C. Thought Content:
• Delusions: (Persecutory delusion/ delusion on reference/hypochondrial
delusion/delusion of grandeur/delusion of control/nihilistic delusion)
• Ideas: [Worthlessness/helplessness/hopelessness/guilt/death wishes
(suicidal ideation)]
• Phobias: (irrational fear)
• Any preoccupations

24. PERCEPTION:
1. Illusion:
2. Hallucination:

25. ILLUSION & HALLUCINATION:
Illusion:
Misinterpretation of stimuli arising from an external object.
• Types:
1. Complete- Due to inattention e.g misreading in newspaper or missing misprints.
2. Pareidolia- Vivid illusion without any effort by the patient.
Hallucination:
A false perception which is not a sensory distortion or a misinterpretation, but which
occurs at the same time as real perception.
• Type:
1. Auditory
2. Visual
3. Tactile or Olfactory
4. Hypnogogic or Hypnopompic (feelings of suffocation, sensations of floating)

26. COGNITION:
1. Consciousness: Conscious/drowsy/comatose
2. Orientation:
• Time (approximate day and time spend in hospital)
• Place (where he or she is?)
• Person (Name the person with whom he or she having contact)
3. Attention: Normally aroused/aroused with difficulty
• Digit forward ( Count 1-20)
• Digit backward (Count 20-1)
4. Concentration: Normally sustained/sustained with difficulty/distractible
• Names of months (backwards)
• Names of weekdays (backwards)

27. CONTINUE……..
1. Memory:
• Immediate (same test for attention)
• Recent (recent happenings like last meal, visitors) 24
hours
• Remote (personal events, illness related events,
impersonal events)
2. Intelligence: (General Knowledge/ Arithmetic ability)
[Addition, subtraction]

28. INSIGHT: (DEEP UNDERSTANDING)
GRADES:-
• Grade-1: No illness
• Grade-2: Some problem is present, Not sure
• Grade-3: Problem is due to external cause
• Grade-4: Problem is associated with Physical symptoms
• Grade-5: Intellectual insight(knows that he has disease ,some
information about disease)
• Grade-6: Emotional insight: (knows disease + treatment +
future consequences)