Mental Statues Examination- MSE, Slides of Psychology

Download Mental Statues Examination- MSE and more Slides Psychology in PDF only on Docsity!

A structured assessment of behavioral and cognitive functioning.

Mental Status

Examination

(MSE)

 The mental status examination ( MSE ) is an important part of the clinical assessment process in neurological and psychiatric practice.  It is a structured way of observing and describing a patient's psychological functioning at a given point in time, under the domains of appearance, attitude, behavior, mood and affect, speech, thought process, thought content, perception, cognition, insight, and judgment.

Introduction

How is it done?

 The information is collected in different ways:

• Observing the person during conversation or while gathering their personal history.
• Asking specific questions about their feelings, thoughts, and symptoms.
• Sometimes using psychological tests to get deeper insights.  Important Note:
• The MSE is not the same as the Mini–Mental State Examination (MMSE).
• MMSE is a short test mainly used to check for dementia or memory problems.
• MSE is a more detailed and broader look at a person’s overall mental state.

02.Assessment Domains

1.Appearance

In this domain, the clinician observes the patient's physical appearance, including grooming, attire, and demeanor.

 Gesturing refers to the use of hand and body movements to accompany speech or express emotions.  Normal Gesturing: Natural, culturally appropriate hand movements used to emphasize or accompany speech.

• Example: A patient says, "I was so surprised!" while slightly raising their eyebrows and spreading their hands.  Exaggerated Gesturing: Excessive, dramatic, or overly animated hand movements that seem unnatural or distract from speech.
• (While describing a minor event, the patient waves their arms wildly, claps their hands, and repeatedly points to the ceiling.)  Odd Gesturing: Bizarre, inappropriate, or purposeless gestures that do not align with context or speech.
• (The patient repeatedly makes a twisting motion with their hands in the air while discussing their family, with no clear reason or explanation.)

2.Behavior

In this domain, in which overall behavior is obseved such as body language, eye contact, and any noticeable psychomotor agitation or retardation. These aspects can provide valuable insights into the patient's emotional well-being.

Ex:Giriraj Ji

Catatonic Phenomena Description Example

Ambitendency

Repeated hesitation in

completing voluntary

movement

Reaching out then pulling

back hand repeatedly

Automatic Obedience

Obeying all commands

robotically, even strange

ones

Touching wall when told,

without resistance or logic

Stupor

No speech or movement

despite being awake

Silent, motionless,

unresponsive

Rigidity

Fixed resistance to

movement

Arm stays stiff when

examiner tries to move it

Posturing

Maintaining odd or awkward

body positions voluntarily

Standing with arms raised

for long periods

 Orientation

 Time, Date, Day : Whether the patient is well oriented to time (test by asking

the time, date, day, month, year, season, and the time spent in hospital)

 Place :(test by asking the present location, building, city, and country)

 Person (test by asking his own name, and whether he can identify people

around him and their role in that setting)

 Attention refers to the person’s ability to focus on a specific task or stimulus.

• Ask the patient to repeat digits forwards and backwards (digit span test; digit

forward and backward test), one at a time (for example, patient may be able

to repeat 5 digits forward and 3 digits backwards).

• Start with two digit numbers increasing gradually up to eight digit numbers or

till failure occurs on three consecutive occasions.

Type Definition Example Aroused and Sustained The person is alert and can maintain focus throughout the task. Patient listens carefully, follows all instructions, and completes serial subtraction tasks accurately. Aroused but Not Sustained (Usha Ji) Initially alert but loses focus quickly or gets distracted. Starts the task but then looks around, forgets the question, or loses track halfway. Fluctuating Level of alertness and focus goes up and down during the interview. Appears attentive one moment, then stares blankly or becomes confused, then regains attention briefly. Not Aroused (Impaired) Drowsy or minimally responsive; unable to focus at all. Doesn’t respond properly to questions or needs repeated stimulation to stay awake. Seen in stupor or delirium.

 Memory : Memory is the ability to register, store, and retrieve information. a. Immediate Retention and Recall (IR and R)- The ability to register and recall information immediately (within a few seconds). This tests the very short-term memory and attention span. Use the digit span test to assess the immediate memory; digit forwards and digit backwards subtests.(also used for testing attention). Three-word recall test: “I’m going to say 3 words — apple, table, pen. Please repeat them now.” After 2 – 3 seconds, ask: “What were the 3 words I just told you?” Response Interpretation Repeats all 3 words correctly - Intact immediate memory Repeats 1 or 2 correctly - Partially impaired Fails to repeat any - Impaired immediate memory

 Recent Memory: Ability to recall events or information from the past few

minutes to 24 hours.

• “What did you have for breakfast today?”

“What did you do yesterday evening?”

“What time did you come to the hospital?”

• Give an address to be memorised and ask it to be recalled 15 minutes later or

at the end of the interview.

 Remote Memory: Recall of long-term past events (weeks, months, or years

ago).

• “Where were you born?”

“What was the name of your school?”

“When did you get married?”

• Ask for the date and place of marriage, name and birth days of children, any

other relevant questions from the person’s past.