A mental status exam is a detailed psychiatric evaluation that assesses a patient’s physical appearance, attitude, mood, speech, and thinking to determine the correct diagnosis for proper treatment. It combines psychological testing and observation to evaluate symptoms and can help diagnose mental problems beyond a patient’s psychiatric history.
A mental status exam (MSE) is a type of psychiatric evaluation. It is used to determine a patient’s state of mind through the use of observation and a series of questions. A psychiatrist asks questions and observes how the patient initially looks and as he provides answers to questions about symptoms. The current state of mind of the patient is determined by how he looks, behaves and what kind of attitude he displays. Mood, speech, and thinking aspects are also assessed.
To properly diagnose mental problems, psychiatrists must rely on more than a patient’s psychiatric history. Unlike a mini-mental status exam that screens for dementia quickly, a mental status exam is more detailed. It combines psychological testing to determine the symptoms a patient with a psychiatric history experiences. The goal is to gather as much information as possible to get the correct diagnosis for proper treatment.
One of the first aspects of a mental status exam that a psychiatrist must evaluate is the patient’s physical appearance. Weight, age and height are determined and certain types of appearance can suggest different mental problems. Odd or bright clothing choices may suggest that the patient is suffering from mania, while dirty or worn clothing may suggest depression. Patients who exhibit unusual changes in their appearance may be suffering from a personality disorder and signs of addiction suggest that the patient may be seeking self-medication to address mental problems.
The patient’s attitude during a mental status exam is another aspect that psychiatrists look at. The circumstances of each patient influence his attitude towards the clinical assessment and the doctor performing the examination. Patients can be cooperative, uncooperative, and even hostile. Psychiatrists can use these reactions to determine what the diagnosis might be.
A mental status exam also evaluates the mood, speech, and aspects of thinking that a patient has. Mood is determined by how a patient reacts and how she responds to questions about symptoms. Based on these criteria, a psychiatrist can take into consideration the patient’s current mood with her symptoms to make a diagnosis. For example, a patient who cannot describe a state of mind in his own words may suffer from alexithymia.
Thought process and content are important aspects of a mental status exam. Psychiatrists need to understand how a person processes information and what exactly their thought processes involve. More specifically, psychiatrists look for the occurrence of delusions, phobias and obsessions. Also, the intensity of the content matters. Intensity plays an important role in determining the severity of a mental problem.
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