Mental Status Exam

The mental status test or mental state examination, abbreviated MSE, is an important part of the clinical assessment exercise in psychiatric practice. It is a structured sort of observing and describing a patients current state of mind, under the domains of appearance, attitude, behavior, mood and affect, speech, thought process, thought content, perception, cognition, cortical potential and judgment. 1 There are some minor variations in the subdivision of the MSE and the chronological succession and names of MSE domains.The offer of the MSE is to obtain a comprehensive cross-sectional definition of the patients mental state, which, when combined with the biographical and historical education of the psychiatric history, allows the clinician to take up an accurate diagnosis and formulation, which are required for coherent treatment planning. The information are collected through a combination of direct and substantiating means unstructured observation while obtaining the bi ographical and social information, centre questions about current symptoms, and formalised psychological tests.The MSE is not to be confuse with the mini-mental state examination (MMSE), which is a brief neuro-psychological screening test for dementia. suppositious foundationsedit The MSE derives from an approach 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 dash to comprehend a patients experience is through his or her own comment (through an approach of empathic and non-theoretical enquiry), as distinct from an interpretive or psychoanalytical approach which assumes the analyst might understand experiences or processes of which the patient is unaware, such(prenominal) as defense mechanisms or unconscious drives.In practice, the MSE is a blend of empathic descriptive phenomenology and empirical clinical observ ation. It has been argued that 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 overlord meaning which was concerned with comprehending a patients subjective experience.ApplicationThe mental status examination is a core skill of qualified (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 fall at the time of the interview.Further, information on the patients insight, judgment, and capacity for abstract conclude is used to inform decisions about treatment strategy and the choice of an eliminate treatment setting. 9 It is carried out in the manner of an informal enquiry, victimisation a combination of open and closed questions, supplemented by structured tests to assess cognition. 10 The MSE net 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 Information 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.