MSE Assists in Mental Health Evaluation

The mental health status examination (MSE) is an important component of assessing a person’s mental condition. It often is used in conjunction with a patient history and may provide a roadmap to further assessment. It combines the objective observations of the clinician, as well as descriptions provided by the patient.

The MSE has main components. While each form may include slightly different wording, or may break these down into distinct sets, it likely will cover:

1) General Appearance, such as physical appearance, grooming, posture and eye contact.

2) Speech and Motor Activity, or how the patient relates to open-ended questions. “One might discern problems in output or articulation such as the hypophonia of Parkinson’s disease, the halting speech of the patient with word-finding difficulties, or the rapid and pressured speech of the manic or amphetamine-intoxicated patient,” the authors wrote in Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Examiners are able to observe things like tics or unusual mannerisms.

3) Mood and Affect, or the patient’s immediate expression of emotion and the more sustained emotional makeup. “Affect must be judged in the context of the setting and those observations that have gone before,” the authors noted in Clinical Methods.

4) Speech, including the rate of speech, whether it is rapid, slow, hesitant or rambling.

5) Cognition, including attention and concentration. Can the person recite the months of the year backwards, for instance? Do they recall family birthdays? And can they recall a name and address five minutes later?

6) Thought Patterns. Are thoughts clear and coherent, or cloudy and confused? Are responses relevant to the topic being discussed?

7) Level of Consciousness, or the state of wakefulness and response to stimuli.

The MSE is structured so that health professionals can gauge changes that occur over time. The Folstein Mini-Mental State Exam may be used in conjunction with some of the clinician observations. It is a more straightforward test, assessing things like memory, ability to follow written instructions and awareness of the city and state.

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Sources:
Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition: https://www.ncbi.nlm.nih.gov/books/NBK320/
Folstein Mini-Mental State Exam: http://www.dementiatoday.com/wp-content/uploads/2012/06/MiniMentalStateExamination.pdf