MSE

observing and describing

Mental Status Evaluation is a structured way of
_______________________ a client's psychological functioning at a given point in time.

comprehensive cross-sectional description

MSE conducted to obtain _________________ of the client’s mental state which, when combined with the biographical and historical information allows the clinician to make an accurate diagnosis and formulation which are required for coherent treatment planning

mental status examination (MSE

the sum of the clinician's observation and impressions after the cross sections of the client's psychological life.

FALSE

MSE is an NOT evaluation of how that client was in the past or will be in the future.

TRUE OR FALSE:

MSE is an evaluation of how that client was in the past or will be in the future.

current state

The MSE is an evaluation of the client's ________.

clinical presentation and his/her educational and cultural background

The elements of the evaluation depend on the client's ______________________________________.

TRUE

TRUE OR FALSE:

The MSE includes observing the client's behavior and describing it in an objective and non-judgmental manner

Appearance

The following physical characteristics of the client should be included: apparent age, manner of dress, cleanliness, posture, unusual gait, facial expressions, eye contact, pupil dilation or constriction, and general state of health and nutrition

Cognitive Disorder

Unkempt and disheveled

drug intoxication

Dilated pupils are sometimes associated with ___________

narcotic addiction

pupil constriction may indicate __________

depressed individuals

Stooped posture is often seen in _______________.

Manic

_______ clients may dress in colorful or unusual attire.

Motoric Behavior

Refers to the client's physical movement

1. Level of Activity

2. Type of Activity

3. Unusual gestures or mannerisms

The clinician should record the following motoric behavior observations on:

Level of Activity

lethargic, tense, restless or agitated.

Type of Activity

tics, grimaces, or tremors.

Unusual gestures or mannerisms

compulsions

1. anxiety

2. mania

3. stimulant abuse

Excessive body movement may be associated with:

1. depression

2. organicity

3. catatonic

4. schizophrenia

5. drug-induced stupor

Minimal body activity may suggest:

medications

Tics and grimaces may suggests adverse effects from _________.

obsessive-compulsive disorder

Repeated motor movements or compulsions may indicate ___________.

delirium or toxic conditions

Repeated picking of lint or dirt off clothing is sometimes associated with ____ or ______.

schizophrenia

Minimal eye contact may indicate:

paranoid states

Scanning of environment in ____________.

Attitude

Describes how the client relates to the clinician during the interview. Has the client been hostile, uncooperative, irritable, guarded, apathetic, defensive, suspicious, or seductive?

paranoid or substance-abuse client

Suspiciousness may be evident in the _________________ client.

anxiety disorder

Irritability may suggest

depression and conversion disorder

Apathy may be associated with:

bipolar illness

Seductive behavior with ________.

Mood

client's self-report of his/her prevailing emotional state that reflects the client's perception of the world.

Affect

the outward expression of the client's inner experience

1. Labile

2. Flat

2 TYPES OF AFFECT

Labile affect

describes sudden shifts in emotional state. The client may laugh one minute and cry the next without a clear stimulus.

Flat affect

describes a shallow and blunted emotional state. Facial expression and voice lack spontaneity

25% of depressives

Suicidal ideas in ____________ and they are notably awakens early morning.

mania

Elation in ________, and decreased need for sleep

manic clients

Labile affect is often seen in _______.

schizophrenic

Flat, incongruent affect is often evident with ___________.

cognitive disorder and catatonia

Loss of prosody in _______________.

flat affect

Do not confuse medication adverse effect with ____________.

Speech

Usually described in terms of rate (rapid, slow, halting), amount (taciturn, lacking spontaneity, grandiose), tone (monotone, singsong, slurred), impairment (dysarthria, stuttering, echolalia), and aphasia.

Manic

______ clients show pressured speech.

depression

Paucity of speech in _________.

cognitive disorder

Uneven or slurred speech in ___________.

Perception

a variety of distortions of sensory experiences and their interpretation.

Hallucinations

false perceptions of a sensory stimulus

schizophrenia

Auditory hallucinations are the most common and suggest _________.

organicity

Visual hallucinations suggest __________.

1. organic mental disorder

2. cocaine abuse

3. delirium

4. tremens

Tactile hallucinations suggest:

Illusions

misinterpretations of an actual sensory stimulus

Thought Content

Refers to the specific meaning expressed in the client's communication. It is the 'what' of the client's thinking

Religious Delusion

Belief that one is favored by a higher being or is an instrument of that being.

Somatic Delusion

Belief that one's body or parts of one's body are diseased or distorted.

Grandiose Delusion

Belief that one possesses greatness or special powers

Paranoid Delusion

Excessive or irrational suspiciousness and distrustfulness of other

Thought Broadcasting

Delusion about thoughts being aired to the outside world.

Thought Insertion

Delusion that thoughts are placed into the mind by outside people or influences.

Depersonalization

Feeling of having lost self-identity and that things around the person are different, strange, or unreal.

Hypochondriasis

Somatic over-concern with the morbid attention to details of body functioning.

Ideas of Reference

Incorrect interpretation of causal incidents and external events as having direct personal references.

Magical Thinking

Belief that thinking equates with doing, with a lack of realistic relationship between causes and effect.

Nihilistic Ideas

Thoughts of nonexistence and hopelessness.

Obsession

Idea, emotion, or impulse that repetitively forces itself to consciousness although it is unwelcome.

Phobia

Morbid fear associated with extreme anxiety.

schizophrenia

Mood-incongruent delusions point to ___________.

delirium

Illusions are common in _______.

schizophrenia

Thought insertion is characteristic of ____________

anxiety disorders

Obsessions and phobias are associated with:

Thought Process

Refers to the 'how' of the client's self-expression. It assesses the patterns or forms of the verbalization of speech.

Circumstantial

Thought and speech associated with excessive and

unnecessary detail that is usually relevant to a question; an

answer is ultimately given.

Echolalia

Direct repetition of the interviewer's words.

Flight of Ideas

Over productive speech characterized by rapid shifting from one topic to another and fragmented ideas.

Loose Associations

Lack of a logical relationship between thoughts and ideas that renders speech and thought inexact, vague, diffused

Neologisms

New word or words created by the client, often a blend of other words.

Perseveration

Repetition of the same words or phrases occurs despite the interviewer's direction to stop.

Tangential

The client wanders off the subject similar to circumstantial, but the client never returns to central point and never answers original question.

Thought Blocking

Sudden stopping in the train of thought or in the midst of a sentence.

Word Salad

Series of words that seem completely unrelated.

schizophrenia or other psychotic disorders

.Loose associations and neologisms point to ___________ and ___________.

mania.

Flight of ideas indicates _______

paranoid

Circumstantiality may be a sign of _______ thinking

psychotic disorders

Perseveration is often associated with brain damage and ___________.

thought disorganization

Word salad represents the highest level of _________.

Sensorium

Assessment of several cognitive functions and the client's orientation to the current situation.

delirium and dementia

Abnormalities of the sensorium are seen in _____ and _______, and they raise a suspicion of an underlying medical or drug-related cause ofsymptoms

1. Person

2. Place

3. Time

Description such as “oriented x3” during intake or other points means client is oriented to:

1. Person

2. Place

3. Time

4. Situation

oriented x4

organic mental disorder

Clients with ___________ may give grossly inaccurate answers, with orientation to person remaining intact longer than orientation to time or place.

schizophrenia

Clients with ________ may say they are someone or somewhere else, or a personalized orientation to his environment

Delirium or dementia

____ or _____ shows clouded or wandering sensorium.

Memory

Assessment of the ability to recall past experiences.

Remote Memory

recall of events, people and information from the distant past.

Recent Memory

recall of events, people and information from the past week or so.

Immediate Memory

recall of information to which a person was just exposed.

dementia of the Alzheimer's type

Clients with _______________ retain remote memory longer than recent memory.

Anxiety and depression

______ and _____ can impair immediate retention and recent memory

paranoid

Hypermnesia is seen in ________ personality

benzodiazepines

Anterograde amnesia occurs after taking certain drugs like ____________.