TOLEDO, MEEVIE LOVE D.

NMD 2A
NEUROPSYCHIATRY

1. Make an Outline of the Mental Status Examination.

A. Appearance, attitude and behavior

Description of appearance, hygiene

Attitude toward examiner

Psychomotor activity

B. Speech

C. Mood and Affect

Subjective and Objective Mood

Affect variability and appropriateness

Presence of Anxiety

Assessment of Suicidality

D. Thought and Language

Production

Form

Content (Obsessions/Delusions)

E. Perceptions

Hallucinations/Illusions

Depersonalization

Derealization

F. Cognitive Function

Level of Consciousness

Orientation

Concentration

Memory

Intelligence

G. Insight and Judgment

2. Try to do the MSE basing on the video presented.

A. Appearance, attitude and behavior

Description of appearance, hygiene: the patient is well-groomed and looks healthy

Attitude toward examiner: the patient is alert; he responds fully and attentively to the examiner

Psychomotor activity: he keeps on looking on the ground when talking; there is no unnecessary
movements manifested

B. Speech: the patient speaks slowly and softly; he is very detailed with his stories; the words
are clear and distinct.

C. Mood and Affect

Subjective and Objective Mood: the patient looks worried (objective); the patient told the
examiner that he’s terrified and bothered (subjective)

Affect variability and appropriateness: the patient still maintained to be respectful and calm,
despite all the worries he had

Presence of Anxiety: the patient is anxious with eating his food because his room mates might
have put poison on it

Assessment of Suicidality: the patient have suicidal thoughts by overdosing himself with pills,
but he’s too anxious of going out of his apartment

D. Thought and Language

Production: he expressed his thoughts well

Form: coherent and consistent

Content (Obsessions/Delusions): based on what the patient talked about, he is suffering from
anxiety

E. Perceptions: the patient has hallucinations

F. Cognitive Function: *cognitive function was not assessed in the video*

Level of Consciousness

Orientation

Concentration

Memory

Intelligence

G. Insight and Judgment

Insight: the patient sees himself as physically healthy, and that the only thing that is wrong with
him is the unbearable thoughts inside his head. He does not think it’s because of cannabis and
speed he took.

Judgement: he does not want his mom to worry about him, that’s why he agreed to seek
consultation.

3. Please define the following:

a. Rapport: described as that unconscious empathetic relationship to another person

b. Mood: describes the prevailing emotional state of the patient.

c. Affect: refers to how the patient’s mood is expressed or exuded.

d. Normal Thought Process

e. Tangentiality: Marked by skirting the question rather than answering it. Connections
between subsequent thoughts are apparent, but goal is never reached.

f. Circumstantiality: Marked by tedious and unnecessary details but eventually reaches the
point.

g. Looseness of Association: also known as derailment; tangential speech with shifting

topics that are loosely connected or unrelated. The patient is unaware of the lack of
association.

h. Flight of Ideas: an almost continuous flow of accelerated speech with abrupt changes from
one topic to the next. Changes are based on understandable association, play of words, or
distracting stimuli, but ideas are not well connected.
i. Delusion: Fixed, false beliefs that have no basis in reality, are not held by one’s culture, and
from which the patient will not be dissuaded despite evidence to the contrary.

j. Phobia: An irrational, pathologic dread of a specific type of stimulus or situation that results
in marked anxiety and avoidance of the situation.

k. Ideas of Reference

l. Hallucination: Perceptions that occur in the absence of actual stimuli.

m. Judgment: Refers to a person’s ability to handle finances; manage day to day activities;
and avoid danger, including exposure to heat, cold, malnutrition, and crime.

n. Insight: Refers to awareness of factors influencing one’s situation.

o. Levels of Insight: (1)complete denial of illness; (2)slight awareness of being sick and
needing help; (3)awareness of being sick but blaming it on others, on external factors, or on
organic factors; (4)awareness that illness is caused by something unknown in the patient;
(5)intellectual insight; and (6)true emotional insight.