Learning Objectives: The Mental Status Exam 1.

List the four purposes for the Mental Status Examination (MSE) Organized system for observing and evaluating a person’s mental status at a specific time 2. Systematic written record 3. Provides essential diagnostic data 4. Baseline for measurement of patient changes
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List the major areas of the MSE as presented in the lecture 1. General description a. Appearance (posture, poise, clothing, grooming, gait, etc) b. Behavior & psychomotor activity (mannerisms, gestures, eye contact) c. Rapport (with the doctor) 2. Mood and Affect (how patient feels) 3. Speech (quantity, quality, rate, volume, idiosyncrasies) 4. Perceptual disturbances a. Hallucination b. Illusion c. Depersonalization/derealization (detachment feelings from self or environment) 5. Thought a. Thought Process (slow or fast, abundance or paucity of ideas, confusion, blocking, relevance, vagueness, etc) b. Thought Content i. Preoccupations 1. Obsessions 2. Compulsions 3. Phobias ii. Suicidal/Homicidal ideation iii. Delusion iv. First Rank psychotic symptoms 1. Ideas of reference 2. Thought withdrawal, insertion, broadcasting 6. Sensorium and Cognition a. Alertness and LOC b. Orientation to Person, place, time c. Memory i. Remote (years) ii. Recent past (months) iii. Recent (hours, days) iv. Immediate (ability to repeat digits, objects) d. Attention e. Concentration f. Abstract Thinking g. General fund of information and estimation of intelligence

7. Impulse Control 8. Insight and Judgment 9. Reliability

3. Define and correctly apply the following terms: mood, affect, illusion, hallucination, obsession, compulsion, phobia, delusion, thought content, thought process, judgement, insight, cognition, memory 1. Mood = pervasive, subjective emotional tone reported by the patient (or sometimes inferred) 2. Affect = patient’s external expression of emotional responsiveness, observed by doctor. State if it’s appropriate, how rapid it changes. 3. Illusion = misperception of a real external stimulus 4. Hallucination = false perception in the absence of an actual external stimulus. 5. Obsession = intrusive, anxiety-producing thought that can’t be eliminated by logic or reasoning 6. Compulsion = repetitive, unwanted urge to act contrary to one’s ordinary instincts/ standards in order to reduce anxiety 7. Phobia = persistent, irrational fear of a specific stimulus or situation resulting in compelling urges to avoid the feared stimulus that cannot be corrected by reasoning 8. Delusion = firm, fixed, false belief 9. Thought Content = preoccupations, suicidal or homicidal ideations, delusions, or normal 10. Thought Process = how a patient expresses himself, form of thinking 11. Judgment = understanding of outcome of own behavior, consequences of own actions, and applying this awareness to daily living (social judgment) or hypothetical situations 12. Insight = degree of awareness and understanding of illness, emotions 13. Cognition = higher level functioning involving computation, general knowledge, concentration, attention, abstract thinking, intelligence, vocabulary, memory, etc. 14. Memory = ability to retain and recall information. 4. Describe observations in terms of the MSE ● Appearance—age, race, sex, body type or weight, eye contact ● Behavior—agitaiton, retardation, catatonia, posturing, catalepsy, echopraxia ● Etc etc etc