MSE
A person is oriented to these 3 things if they are Oriented x 3
What are:
person, place and time
How you might describe someone who lives in a homeless shelter, has not had a shower in about a week and is wearing clothes with several apparent stains
What is: unkept, disheveled or not well-groomed
The difference between affect and mood
What is:
What you can see about a person's emotional state vs. what the person says they feel
An example of "tangential speech"
What is the following statement:
Tangential Response: “Oh, the theater was freezing! I had to borrow my friend’s jacket—she’s always so prepared for everything. It reminded me of that trip we took to Banff, actually. We almost got caught in a snowstorm, but thankfully we found this cozy little café with the best hot chocolate…” - they never answer the original question and go off on a tangent
The difference between thought process and content
What is: how the patient expresses themselves vs. what they talk about
What is 15-30 minutes. Typically, a comprehensive mental status exam takes about 15-30 minutes. But don't sweat it if it takes longer when you're just starting out. With practice, you'll get faster and smoother!
Instead of simply stating that a patient appears anxious, behaviours you document that would indicate this (i.e., by looking at the patient, what about their behaviour has you thinking that they are anxious?)
What are symptoms such as:
-Tapping foot
-Wringing hands
-Rapid breathing
-Nail bitting
A quantitative way of assessing mood
What is:
Having the patient rate their mood on a scale of 0-10 (0=worst ever, 10=best ever).
An example of "circumstantial speech"
What is the following statement:
Circumstantial Response: "Oh, you're asking if I brought the report? So funny story—this morning, I woke up earlier than usual because my neighbor's dog wouldn't stop barking. That reminded me I needed to feed my own cat, but I was out of cat food, so I rushed to the store. And on my way, I ran into my old high school teacher, which was wild because we talked about life for a good ten minutes. Anyway, when I got back, I realized I’d forgotten the report on the kitchen table."
The actual answer is: “No, I forgot the report.” But the speaker takes a scenic route through their morning before getting to the point.
Different types of delusions (at least 3)
What are:
-grandiose delusions
-delusions of reference
-persecutory
-religious
The age ranges for which the MSE can be completed
What are all ages!
Term that means that the person's clothing doesn’t match the weather or situation (e.g., wearing a winter coat in summer).
What is "incongruent attire"
This defines "euthymic"
What is:
Mood in the "normal" range, which implies the absence of depressed or elevated mood
An example of "flight of ideas"
What is the following statement:
Flight of Ideas Response: "I’m going to write a book, maybe about time travel—Einstein had some wild theories, didn’t he? Speaking of travel, I need to book that trip to Greece, the olives there are amazing. Olives are green—my favorite color! Green reminds me of my childhood bike, I used to race it down the street like I was in the Tour de France, which is coming up soon—I should buy a new jersey..."
These 5 aspects of thought content should be documented on each shift
What are:
-Suicidal Ideation
-Homicidal Ideation
-Urges to self-harm
-Hallucinations
-Delusions
The difference between the use of the Mental Status Examination (MSE) vs. the Mini-Mental Status Examination (MMSE)
What is the following: while the MSE is used broadly in mental health evaluations, the MMSE is particularly useful for detecting and monitoring cognitive decline, such as in cases of dementia or delirium.
Definition of "Cachectic"
What is extremely thin or wasted appearance, often due to chronic illness or severe eating disorder
An example of noncongruence between mood and affect
What is:
When someone's mood is “good" or "fine” despite ongoing tearfulness throughout interview
6 ways that speech can be described
What are:
-Clarity
-Rate
-Quantity
-Tone
-Flow
-Volume
This type of hallucination is the most common
What are auditory hallucinations
The 10 categories identified in the Mental Status Examination
What are:
1) Appearance
2) Behaviour
3) Mood
4) Affect
5) Speech
6) Thought Process
7) Thought Content
8) Cognition
9) Judgement
10) Insight
At least 5 attributes of appearance that should be included in the MSE
What are:
-Gender identity
-Does or does not appear stated age
-Groomed or unkept
-Body type (thin, overweight)
-Eye contact
This defines "alexithymia"
What is:
When the patient incapable of describing mood
The pattern of speech that occurs when words are strung together based on sound (rhyme or alliteration) rather than meaning. The result is speech that may sound poetic or musical but lacks logical coherence. It is often observed in schizophrenia or manic episodes of bipolar disorder, where disorganized thought processes influence language
What is "clanging" or "clang associations"
The difference between judgement and insight
What is:
Thinking of insight as understanding there’s a problem, and judgment as knowing how to deal with that problem appropriately. A person might have insight ("I have schizophrenia") but impaired judgment ("I stopped taking my meds because I read online that I don’t need them").