Guidelines for a Mental State Examination (mse)



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Guidelines for a Mental State Examination (MSE)



Appearance

E.g. posture, body habitus, grooming


Behaviour

Features e.g. mannerisms, tics

Descriptor e.g. restless, agitated, aggressive
Cooperation and attitude

E.g. friendly, cooperative, uncooperative, suspicious, hostile, evasive, seductive, perplexed



Affect and Mood

Affect: patient’s observable emotions

Range: e.g. flat, blunted, restricted, normal, labile

Appropriateness: appropriate/inappropriate in the context of the patient’s speech or ideation

Mood: descriptors include depressed, anxious, normal, irritable, angry, euphoric. If possible describe how the patient perceives their own mood, preferably using the patient’s own words.


Speech

Rate: slow, normal, rapid or pressured


Volume: soft, normal, loud or shouting


Quantity: nil spontaneous, normal, talkative

Quality: accent, rhythm, impediments
Thought form and content (judged from listening to the patient’s speech)

Thought form: e.g. thought-blocking, racing thoughts, logical connection, flight of ideas, loosening of association
Thought content: any pathological features such as: preoccupations, overvalued ideas, delusions, ideas of reference, obsessions, compulsions.

(What is the subject matter of the patient’s thoughts or preoccupation? Any suicidal or homicidal ideas?)




Perception

Any unusual sensory phenomena such as: hallucinations (especially auditory), illusions, heightened perception, derealisation/depersonalization



Cognition

Level of consciousness: alert, drowsy (easily aroused), stupor (aroused only by vigorous stimuli), coma (unable to be aroused)


Memory: immediate, short-term (recent) and long-term (remote)


Orientation: time, place and person


Concentration: abstract thinking capacity


Insight

An individual’s awareness of their illness and its effects and implications: e.g. Good, partial or poor




Judgement

Ability to accurately assess a situation and act appropriately in response: e.g. intact or impaired



Summary
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