Mental State Examination

Warning

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.

Last reviewed: 21/02/2024

Next review date: 21/08/2024

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

Author email(s): mypsych@ggc.scot.nhs.uk.

Reviewer name(s): Medical Education Fellow, NHS Lothian.