Mental State Examination


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


Rapport and eye contact

Activity/retardation, pre-occupation/attentiveness, irritability etc.


Euthymic, elated, depressed, labile, incongruous, blunted


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)


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




Cognitive assessment


Attention and concentration


Intelligence and general knowledge



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.

Editorial Information

Last reviewed: 03/04/2024

Next review date: 03/04/2025

Author(s): Medical Education Fellow, NHS Lothian.

Author email(s):

Approved By: NHSGGC MyPsych Editorial Board

Reviewer name(s): NHSGGC MyPsych Editorial Board.