How would you describe a speech in a mental status exam?

Speech is evaluated passively throughout the psychiatric interview. The qualities to be noted are the amount of verbalization, fluency, rate, rhythm, volume, and tone. It is of key importance to note the amount a patient speaks. If the patient speaks less than normal, they may be experiencing depression or anxiety.

How do you describe speech in MSE?

Rate ranges from “poverty of speech” with few utterances to “pressure of speech”, spontaneity with little or no spontaneous utterances to circumstantiality with overinclusion of detail, volume: from low to high, rhythm: monotonous, without variation or inflection; staccato, with frequent pauses between fluent speech.

How do you write a mental status exam?

A good report is brief, clear, concise, and addresses the areas below:

1. Appearance.
2. Behavior/psychomotor activity.
3. Attitude toward examiner (interviewer)
4. Affect and mood.
5. Speech and thought.
6. Perceptual disturbances.
7. Orientation and consciousness.
8. Memory and intelligence.

How do you assess mood in mental status exam?

It is typically assessed by evaluating the patient’s response to external stimuli and can be described using the following:

1. Alertness. A state of awareness of oneself and the surrounding environment.
2. Somnolence. A state of drowsiness from which a patient can be easily aroused.
3. Lethargy.
4. Obtundation.
5. Stupor.
6. Coma.
7. Delirium.

What is a normal affect?

Range: Affect can be described as within normal range, constricted, blunted, or flat. • In the normal range of affect can be variation in facial expression, tone of voice, use of hands, and body movements. • When affect is constricted, the range and intensity of expression are reduced.

What should I write in MSE?

This MSE includes all 10 aspects: appearance, behaviour, speech, mood, affect, thoughts, perception, cognition, insight and judgement and clinical judgement….

1. APPEARANCE. Observing a patient’s appearance can help you identify clues about their mental status.
2. BEHAVIOUR.
3. SPEECH.
4. MOOD.
5. AFFECT.
6. THOUGHTS.
7. PERCEPTION.
8. COGNITION.

How do you do MSE in mental health?

Key principles in the approach to MSE: Maintain privacy, encourage open conversation and always acknowledge and respect the patient’s concerns and distress. Write down the patient’s words and the order in which they are expressed verbatim. This should avoid misinterpretation.

Why is the mental status examination useful?

The mental status examination is useful in helping differentiate between a variety of systemic conditions, as well as neurologic and psychiatric disorders ranging from delirium and dementia to bipolar disorder and schizophrenia.

What is a full affect?

The person may show a full range of affect, in other words a wide range of emotional expression during the assessment, or may be described as having restricted affect. The affect may also be described as reactive, in other words changing flexibly and appropriately with the flow of conversation, or as unreactive.

How do I remember MSE?

The mnemonic ASEPTIC can be used to remember the components of the Mental Status Examination.

1. A – Appearance/Behaviour.
2. S – Speech.
3. E – Emotion (Mood and Affect)
4. P – Perception (Auditory/Visual Hallucinations)
5. T – Thought Content (Suicidal/Homicidal Ideation) and Process.
6. I – Insight and Judgement.
7. C – Cognition.

What is the purpose of the mental state examination?

Describe the general purpose and component parts of the Mental State Examination (MSE), specifically patients’ speech and thought. Evaluate patients’ speech and thought in their mental state and use appropriate terminology to describe abnormalities.

How to evaluate speech and thought in the mental state?

Evaluate patients’ speech and thought in their mental state and use appropriate terminology to describe abnormalities. Thank you to Neelom Sharma, Alexandra Pittock, Meroe Grove, Maia Forrester and Mercedes Smith for their major contributions to the content of this module.

Are there any open source mental state exams?

Proprietary and open-source clinical examination tools are available, such as the Mini-Mental State Examination and the Mini-Cog. Physician judgment is necessary in selecting the most appropriate tool for an individual patient.

Is the mental status examination a separate interview?

The examination is not done separately but is an integral part of the assessment interview. Questions that relate to mental status are framed as part of the overall assessment and not as a separate pursuit.