Mental status examination

mental status examination

1. MENTAL STATUS EXAMINATION By: Mrs. Ekjot Kaur Assistant Professor,SNS&R Sharda University

2. Nurse’s capacity to observe and describe the behavior accurately can provide valuable information about a patient and a patient’s mental state. INTRODUCTION

3. The mental status exam (MSE) is the psychological equivalent of a physical exam that describes the mental state and behavior of the person being seen. It includes both objective observation & subjective description given by the patient. DEFINITION

4. MSE provides information for diagnosis and assessment of disorder and response to treatment. It is important to ascertain what is normal for the patient. For example:- some people always speak fast! PURPOSES

5. COMPONENTS

6. Appearance Facial expression Level of grooming Level of cleanliness Mode of entry Behaviour Co- operativeness GENERAL APPEARANCE AND BEHAVIOUR

7. Eye- to- eye contact Psychomotor activity Gesturing Other movements Compulsive acts Hallucinatory behavior GENERAL APPEARANCE AND BEHAVIOUR

8. INITIATION: Spontaneous/ speaks when spoken to/ mute. REACTION TIME: normal/ delayed/ difficult to assess. RATE: normal/ slow VOLUME: normal/ increased/ decreased. TONE: normal/ high pitch/ low pitch. RELEVENCE: fully relevant/ irrelevant. SPEECH

9. Subjective Objective Predominant mood state : irritate/ blunted/ anxious/ fearful/ panic/ aggressive. Appropriate : relevance to situation and thought. MOOD AND AFFECT

10. Thought is divided into: Form of Content of thought thought THOUGHT

11. also known as stream of thought. a way person thinks. Form of thought can be logical or completely illogical. FORM OF THOUGHT

12. Flight of ideas: thinking process is so rapid that no idea is completed. Circumstantiality : many unnecessary details are added to flow of thought before the final goal is reached. DISORDER OF FORM OF THOUGHT

13. Word salad: group of words that put together randomly without logical connection. Incoherence: no sense can be extracted from his speech. CONTT…..

14. Tangential thinking: thinking process follows a series of related topics but goal is not reached. Blocking: sudden interruption in thought process. Clang Association: Associative disturbance person follow one word with another. CONTT…..

15. Retardation: the initation and progress of thought is very slow. Preservation: is involuntary and morbid repetition of specific word or ideas. Neologism: person invents new words. CONTT…..

16. Disorder of content of thought include delusions, pre- occupation, obsessions and compulsions, phobias. CONTENT OF THOUGHT

17. false beliefs which are irrational and not shared by person. DELUSIONS

18. Delusion of grandeur Delusion of self accusation Delusion of persecution Delusion of reference Delusion of sin & guilt Delusion of poverty Delusion of nihilism Delusion of control Hypochondrical delusion TYPES OF DELUSIONS

19. Obsessions Phobias OTHER DISORDER COME UNDER CONTENT OF THOUGHT

20. A process of awareness resulting from the act of stimulus upon sense organs. PERCEPTION

21. ILLUSION : is subjective perversion of an objective content. i.e. the subject himself puts wrong meaning to the subject. HALLUCINATION: defined as a sensory experience in the absence of a stimulus or an object. DISORDER OF PERCEPTION

22. Auditory hallucinations Visual hallucinations Olfactory hallucination Gustatory hallucinations Tactile hallucinations TYPES OF HALLUNICATIONS

23. DEJA VU: a subjective feeling that an experience, which is occurring for the first time, has been experienced before. JAMAIS VU: failure to recognize events that have been encountered before. OTHER DISORDERS OF PERCEPTION

24. Consciousness: conscious/ cloudy/ unconscious. Orientation: time, place and person. Attention: normally aroused/ aroused with difficulty. Checked by: digit forward, digit backward COGINITIVE FUNCTION

25. Concentration: normal or distract. Concentration is checked by different methods. Like – calling names of month (backwards) Names of weekdays(backwards) Memory: immediate, recent and remote memory. Intelligence: is includes general fund of information.

26. Abstraction: is multidimensional thinking with ability to use metaphors appropriately. -similarities between paired objects - dissimilarities b/w paired objects Judgment: ability to camparing and evaluating alternatives for the purpose of deciding on a course of action.

27. Is awareness of one’s own mental condition. Person who are aware of their illness and seek treatment are said to have insight. INSIGHT