MSE

Created by

Jessica Jardine

Cards (26)

What are the domains of the MSE?
Appearance & behaviour
Speech
Mood & affect
Thoughts
Perception
Insight & judgement
Risk
What is included in appearance?
Personal hygiene
Clothing
Physical signs of underlying difficulties
Stigmata of disease
Weight
Surrounding objects
What is included in behaviour?
Engagement & rapport
Eye contact
Facial expression
Body language
Psychomotor activity
Abnormal movements/postures
What is included in speech?
Rate
Quantity
Tone
Volume
Fluency & rhythm
What is included in mood?
How the patient is feeling
What is included in affect?
Apparent emotion
Range & mobility of affect (does it remain the same, exaggerated etc.)
Intensity of affect (heightened, blunted)
Congruency of affect -> does affect seem in keeping with content of thoughts
What is included in thought?
Form - process & organisation
speed
flow & coherence
Content
abnormalities...
delusions
obsessions
compulsions
overvalued ideas
suicidal thoughts
homicidal/violent thoughts
Possession
insertion
withdrawal
broadcasting
What are the abnormalities of thought flow & coherence?
Loose associations
Circumstantial thoughts
Tangential thoughts
Flight of ideas
Thought blocking
Perseveration
Neologisms
Word salad
What are loose associations?
Moving rapidly from one topic to another with no apparent connection between the topics
What are circumstantial thoughts?
Thoughts which include lots of irrelevant and unnecessary details but do eventually come back to the point
What are tangential thoughts?
Digressions from the main conversation subject, introducing thoughts that seem unrelated, oblique, and irrelevant
What is flight of ideas?
Fast, pressured speech
Ideas run into one another, making it difficult for the observer to follow the flow of speech
What is thought blocking?
Sudden cessation of thought, typically mid-sentence, with the patient unable to recover what was previously said
What is perserveration?
Repetition of a particular response (such as a word, phrase or gesture) despite the absence/removal of the stimulus (e.g. a patient is asked what their name is, and they then continue to repeat their name as the answer to all further questions)
What is neologisms?
Words a patient has made up which are unintelligible to another person
What is word salad?
Speaking a random string of words without relation to one another
What is included in perception?
Organisation, identification and interpretation of sensory information to understand the world around us
Abnormalities...
hallucinations
pseudo-hallucinations
illusions
depersonalisation
derealisation
What are hallucinations?
Sensory perception without any external stimulation of the relevant sense that the patient believes is real
What are pseudo-hallucinations?
Same as a hallucination, but the patient knows it is not real
What are illusions?
Misinterpretation of an external stimulus (e.g. mistaking a shadow for a person)
What is depersonalisation?
Patient feels that they are no longer their ‘true’ self and are someone different or strange
What is derealisation?
Sense that the world around them is not a true reality
What is cognition?
the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses

Are they orientated to time, place & person?
Attention span & concentration levels?
What is insight?
Ability of a patient to understand that they have a mental health problem and that what they’re experiencing is abnormal
What are the subdivisions of risk?
Risk to self
Risk to others
Risk from others
What are the 6 grades of insight?
Grade 0 - lack of self-awareness
Grade 1 - limited understanding of behaviour & connection to mental health problem (may acknowledge a problem)
Grade 2 - partial understanding of behaviour & possible underlying reasons for behaviour (some understanding of MH issue)
Grade 3 - complete & accurate understanding of symptoms, behaviour & motivations (good understanding of how sympts relate to MH condition)
Grade 4 - understand the impact of MH disorder on themselves & others
Grade 5 - deep understanding of inner workings of mind & behaviour