Mental state examination

Psychiatry: The mental state examination

1)Appearance and Behaviour
ØGeneral health
ØDemeanour
ØManner
ØRapport
ØEye contact
ØCleanliness
ØClothing
ØSelf-care or evidence of neglect
ØDegree of co-operation
ØPosture
ØIncreased restlessness
ØAbnormal movements (tics chorea etc)
ØGait

2)Thought Form (speech)
ØRate
ØQuantity
vIncreased = pressure (may be flight of ideas)
vDecreased = poverty
ØPattern of speech
vSpontaneity
vCoherence
vDirectness to the point
vPerseveration
vDerailment
vFlight of ideas
vThought block
ØNeologisms
ØLoosening of associations

3)Mood (subjective) – as expressed by the individual
4)Affect (objective) – the observed external manifestation of mood
ØBlunting
ØLability
ØDepressed
ØElated
ØEuphoric
ØAnxious
ØAngry

5)Thought Content
ØOvervalued ideas
ØObsessions
ØPhobias
ØIdeas of reference
ØDelusions
ØSuicidality

6)Abnormal perceptions
ØHallucinations
ØPassivity
ØThought interference – insertion or withdrawal
ØDepersonalisation
ØIllusions

7)Cognitive assessment
ØLevel of consciousness
ØAttention/concentration
ØMemory
ØOrientation
ØIntelligence

8)Insight