Mental Status Exam (MSE) Note: The MSE is a "snapshot" of a patient at a specific time. You can use the mnemonic "ASEPTIC" — Appearance/behavior, Speech, Emotion, Perception, Thought content/process, Insight/judgement, Cognition • Appearance - Grooming, dress, hygiene, and apparent age -> Ex. disheveled, eccentric clothing, appears stated age • Behaviour - Psychomotor activity, eye contact, movement, and response to non-verbal stimuli (as in psychosis) -> Ex. agitated, avoiding eye contact, responding to internal voices • Speech - Characteristics of speech such as rate, rhythm and volume -> Ex. Pressured speech (rate), stuttering (rhythm) • Mood - Patient's subjective impression of how they feel (often a paraphrase of what the patient says, and may be different than affect) -> Ex. depressed, worried, happy • Affect - Observer's objective impression of how the patient appears to feel. (Type, Range, Appropriate ness, Intensity, and Lability (TRAIL)) -> Ex. restricted range, inappropriate mood, highly labile • Thought form - How thoughts are expressed, including flow and connection between thoughts -> Ex. goal-oriented (normal), flight of ideas (mania), disorganized (schizophrenia), circumstantial • Thought Content - Types of thoughts expressed, including specific themes, delusions, obsessions, and suicidal or homicidal ideation -> Ex. anxiety about work, delusions of persecution, auditory hallucinations • Cognition - Overall intelligence based on vocabulary, grammar, memory, executive function, and inferred level of education -> Ex. formally assessed (MOCA, MMSE), not formally assessed but within normal limits, impaired • Insight, Judgement - Ability to act in ways that are safe, prudent, and in the interest of self and others. Awareness of illness, the symptoms caused by it, and the ability to be introspective about change -> Ex. good, fair, partial, poor #MentalStatusExam #MSE #psychiatry #diagnosis #evaluation #mnemonic #aseptic #history
