Mental Status Exam

The mental status examination or mental asseverate examination, abbreviated MSE, is an important part of the clinical assessment process in psychiatrical practice. It is a structured right smart of observing and describing a patients current secernate of mind, under the domains of appearance, attitude, behavior, mood and affect, speech, thought process, thought content, perception, cognition, insight and judgment. 1 There are some minor variations in the subdivision of the MSE and the sequence and names of MSE domains.The purpose of the MSE is to go a comprehensive cross-sectional description of the patients mental state, which, when combined with the biographic and historical information of the psychiatric history, allows the clinician to make an accurate diagnosis and formulation, which are involve for coherent treatment planning. The info are collected through a combination of direct and indirect means unstructured observation while obtaining the biographical and social i nformation, focused questions about current symptoms, and formalised psychological renders.The MSE is not to be confused with the mini-mental state examination (MMSE), which is a brief neuro-psychological screening test for dementia. Theoretical foundationsedit The MSE derives from an memory access to psychiatry known as descriptive psychopathology4 or descriptive phenomenology5 which developed from the work of the philosopher and psychiatrist Karl Jaspers.From Jaspers perspective it was assumed that the only way to comprehend a patients experience is through his or her own description (through an approach of empathic and non-theoretical enquiry), as distinct from an interpretive or psychoanalytic approach which assumes the analyst might understand experiences or processes of which the patient is unaware, such as defense mechanisms or unconscious drives.In practice, the MSE is a blend of empathic descriptive phenomenology and data-based clinical observation. It has been argued th at the term phenomenology has become corrupted in clinical psychiatry current usage, as a set of supposedly objective descriptions of a psychiatric patient (a synonym for signs and symptoms), is incompatible with the original meaning which was concerned with comprehending a patients subjective experience.ApplicationThe mental status examination is a core skill of fitted (mental) health personnel. It is a key part of the initial psychiatric assessment in an out-patient or psychiatric hospital setting. It is a systematic collection of data based on observation of the patients behavior while the patient is in the clinicians view during the interview. The purpose is to obtain evidence of symptoms and signs of mental disorders, including danger to self and others, that are present at the time of the interview.Further, information on the patients insight, judgment, and capacity for abstract reasoning is used to inform decisions about treatment strategy and the choice of an tolerate trea tment setting. 9 It is carried out in the manner of an informal enquiry, using a combination of open and closed questions, supplemented by structured tests to assess cognition. 10 The MSE can also be considered part of the comprehensive physical examination performed by physicians and nurses although it may be performed in a cursory and abbreviated way in non-mental-health settings.11 data is usually recorded as free-form text using the standard headings,12 but brief MSE checklists are available for use in emergency situations, for example by paramedics or emergency department staff. 1314 The information obtained in the MSE is used, together with the biographical and social information of the psychiatric history, to generate a diagnosis, a psychiatric formulation and a treatment plan.