Mental State Examination
MyPsych App
The MSE (Mental State Examination) is the equivalent of the physical examination you would perform on a patient as part of a physical health assessment.
It is important to note that patients who present with mental health problems require a physical health assessment as part of their assessment also. For more details on this please read the 'Physical Health Assessment' section of the App.
How to Perform an MSE
Although the mental state examination should focus carefully on your observations during the course of the interview, you should also incorporate information obtained on the person's presentation during the course of this episode of illness. If there is evidence of disorder of thought form you should give examples of speech to demonstrate this.
Structure of the MSE
Appearance and behaviour
General description
Self-care
Rapport and eye contact
Activity/retardation, pre-occupation/attentiveness, irritability etc.
Mood
Euthymic, elated, depressed, labile, incongruous, blunted
Speech
Rate, rhythm, tone, volume
Disorders of thought form (continuity of thought as reflected in speech/writing)
- acceleration/retardation
- circumstantiality/loosening of association
- perseveration
- neologisms
- word salad
Disorders of thought content
Pre-occupations (including suicidal ideation)
Overvalued ideas (including ideas of reference)
Obsessions/phobias
Delusions (including disorders of the possession of thought)
- primary, secondary
- disorders of the possession of thought (thought insertion, thought withdrawal, thought broadcasting)
Disorders of perception
Derealisation/depersonalisation
Illusions
Hallucinations
Cognitive assessment
Orientation
Attention and concentration
Memory
Intelligence and general knowledge
Insight/judgement
Insight
What does the patient think is the explanation for their problems? What is their attitude to treatment/ supervision/ staying in hospital?
Adapted from the article entitled 'Mental State Examination' from the MyPsych Student toolkit.