Psychology: Mental Status Examination and Psychiatric Nursing Interview

Mental Status Examination (MSE)

• Mental Status is the total expression of a person's emotional responses, mood, cognitive function, and personality.
• General components of MSE include:

General Appearance and Behavior

• General appearance: body build, physical appearance, comfort level, physical health, grooming, hygiene, self-care, and dressing.
• Facies (non-verbal expression of mood).
• Attitude towards the examiner: cooperation, guardedness, evasiveness, or hostility.
• Comprehension: intact or impaired (partially or fully).
• Gait and posture: normal or abnormal.
• Motor activity: increased, decreased, excitement, stupor, or abnormal involuntary movements (AIMs) like tics, tremors.
• Restlessness, akathisia, catatonic signs, conversion, and dissociative signs.

Catatonic Signs

• Mannerisms: odd, circumstantial caricatures of normal actions.
• Posturing: spontaneous and active maintenance of a posture against gravity.
• Waxy flexibility: decreased response to stimuli and tendency to remain in an immobile posture.
• Negativism: opposition or no response to instructions or external stimuli.
• Ambitendency: pattern of incomplete motor responses in anticipation of a voluntary action.
• Automatic obedience: exaggerated attempt to cooperate with a request or command.
• Echopraxia: involuntary imitation of the movements of another person.
• Psychological pillow: sign of catatonia in which the patient's head is a few centimeters above the bed or pillow.

Speech

• Rate and quantity of speech: whether present or absent (mutism), rapid or slow, pressured or poverty of speech.
• Productivity: increased or decreased.
• Volume and tone of speech: increased or decreased.
• Flow and rhythm of speech: smooth or hesitant.
• Dysprosody: abnormal speech rhythm or melody.
• Blocking: sudden interruption in speech.
• Circumstantiality: indirect or vague speech.
• Tangentiality: speech that is not relevant to the conversation.

Hallucinatory Behavior

• Smiling or crying without reason.
• Muttering, mumbling, or talking to self (non-social speech).
• Odd gesturing in response to auditory or visual hallucinations.