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mental status examination
- 1. MENTAL STATUS EXAMINATION NISHMA.V.M DEPT.APPLIED PSYCHOLOGY
- 2. • psychological equivalent of a physical exam. • it includes both objective observations of the clinician and subjective descriptions given by the patient.
- 4. Components • Assesses general quality of: – amnestic functions – cognitive processing and intellectual functions – form and content of thought – nature, expression, and appropriateness of affect – adaptive and maladaptive behaviors – Symptoms of psychopathology
- 5. What an MSE isn’t • An intelligence test • A detailed memory test • A fully precise measure of cognition, affect, and behavior
- 6. Technique • Direct • Indirect
- 7. Major Components 1. Appearance 2. Motor 3. Speech 4. mood 5. Affect 6. Thought Process 7. Thought Content 8. Perception 9. Cognitive impairments
- 8. 1)Appearance Domains: • Appearance in relation to age • Accessibility • Body Build • Clothing • Cosmetics • Hygiene and grooming • Odor • Facial expression • Eye Contact • Rapport with the therapist It is just as straightforward as it seems
- 9. examples • Mania • Depression • Chronic Schizophrenia, dementia, alcohol/drug de-addiction • Anxiety • Parkinson disease
- 10. 2)Motor activity • Psychomotor activity • Movements • Apparent restlessness • Difficulty in initiation of movements • Waxy flexibility • negativism
- 11. 3) SPEECH DISORDERS OF SPEECH • Aphonia • Slow speech • Fast speech • Pressure of speech • Poverty of speech • Poverty of content of speech Rate low Volume Amount Tone Coherence relevance
- 12. 4) Mood – Euthymic (normal) – Euphoric (elated) – Dysphoric (sad) Mood- the subjective state of a person or how the person “feels”
- 13. 5) Affect: How do they appear to you? • Stability • Range • Appropriateness • Intensity
- 14. 6) Thought process • Circumstantiality • Tangential • Thought blocking • Perseveration • neologism THOUGHT POSSESSION •Thought echo •Thought insertion •Thought withdrawal •Thought broadcasting
- 15. 7)Thought content Refers to the themes that occupy the patients thoguts and perceptual disturbances • Delusions : (control,somatic, erotomanic) • Ideas of reference • Obessions • Preoccupation with suicidal ideas
- 16. 8)perception • Hallucinations • Illusions • Depersonalization • Derealisation
- 17. 9)Cognitive functioning • Orientation • Memory • Abstraction • Intelligence or general information • Judgment • Insight
- 18. Drawbacks – It does not indicate competence, because Pts. who score well may have difficulty with basic activities of daily living – They are subject to interpretive bias and experience of the interviewer – They have a fairly significant false-negative rate, esp. in pts. with right hemisphere lesions – Demographics and culture: Age (>60), education (<9th grade), limited cultural experiences, and low socioeconomic status limit usefulness – Screening questionnaires are less sensitive to cognitive impairments – with young children and others with limited language such as people with intellectual impairement.
- 19. • http://en.wikipedia.org/wiki/Mental_status_exa mination • http://www.ncbi.nlm.nih.gov/books/NBK320/ • http://www.slideshare.net/drjayeshpatidar/ment al-status-examination-20852197 • file:///M:/MSc/thrd%20sem/therpy/mse.pdf • http://www.testandcalc.com/richard/resources/T eaching_Resource_Mental_Status_Examination.p df • http://psychclerk.bsd.uchicago.edu/mse.pdf
- 20. Thanks…
Notes de l'éditeur
- The mental status examination (MSE) is the psychological equivant of a physical exam that describes the mental state and behavior of the person being seen.it includes both objective observations of the clinician and subjective descriptions given by the patient.
- The MSE derives from an approach to psychiatry known as descriptive psychopathology[4] or descriptive phenomenology[5] which developed from the work of the philosopher and psychiatrist Karl Jaspers.[6] From Jaspers' perspective it was assumed that the only way to comprehend a patient's experience is through his or her own description (through an approach of empathic and non-theoretical enquiry), as distinct from an interpretive or psychoanalytic
- The data are collected through a combination of direct and indirect means: unstructured observation while obtaining the biographical and social information, focused questions about current symptoms, and formalised psychological tests
- ] There are potential problems when the MSE is applied in a cross-cultural context, when the clinician and patient are from different cultural backgrounds. For example, the patient's culture might have different norms for appearance, behavior and display of emotions. Culturally normative spiritual and religious beliefs need to be distinguished from delusions and hallucinations - these may seem similar to one who does not understand that they have different roots. Cognitive assessment must also take the patient's language and educational background into account. Clinician's racial bias is another potential confounder.