Mental Status Examination in the ED

see also Mini Mental State Assessment Form, Mental Status Assessment Form

see also complete dictionary of terms used in the MSE


Introduction

THE MENTAL STATE EXAM

Appearance

Behaviour

Conversation

Thought (can be elucidated by conversation or from direct questioning)

Form (Process)

Patients should be able to give history in logical, chronological order and pick up their train of thought if interrupted (ask the patient if they feel their thoughts are muddled)

Content

If a patient's thoughts focus excessively on a limited set of concerns or have no clear basis for them then further psychiatric evaluation is advisable.

The most important features to observe are

Mood/Affect

Important features to note:

Perception

Remember that a patient may indirectly indicate they are experiencing abnormal perceptions from their behaviour - speaking to non-existent people, looking at or manipulating non-existent objects.

Be alert to and specifically inquire about:

Cognition

[ see Mini Mental State Assessment Form]

Abnormalities in the mini-mental state usually are a manifestation of organic disease

Insight & Judgement

Inquire specifically about: