Mental Status Exam
Mental status is the total expression of a person’s emotional responses, mood, cognitive function, and personality
It is closely linked to the individual’s executive functioning, i.e. motivation, initiative, goal formation, planning and performing, self-monitoring, and integration of feedback
The MSE is one component of an exam and may be viewed as the psychological equivalent of the physical exam
It is an important component to a neurological evaluation
Mental Status Exam: Outline
Appearance
Motor Behaviors & Skills
Speech
Affect
Thought Content
Thought Processes
Perception
Intellect
Insight
Mini-Mental Status Exam
MSE: Appearance (Observed)
Age
Sex, Race
Build
Position & Posture
Eye Contact
Dress
Grooming
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(Thought Withdrawal) inserting thoughts into your head? or perhaps (Thought Insertion)
Does it ever seem like your own thoughts are broadcast out loud? (Thought Broadcast)
MSE: Thought Processes (Observed)
Associations
Coherence
Logic
Stream of thought
Clang Associations
Perseveration
Neologisms
Blocking
Attention & Vigilance
MSE: Perception (Inquired)
Hallucinations
Illusions
Depersonalization
Derealization
Questions to check Perception
Hallucinations
Do you ever see (visual), hear (auditory), smell (olfactory), taste (gustatory), and feel (tactile) things that are not really there, such as voices or visions?” (Hallucinations are false perceptions)
Illusions
Do you sometimes misinterpret real things that are around you, such as muffled noises or shadows?”(Illusions are misinterpreted perceptions)
MSE: Orientation (Inquired/Observed)
What is the time ?
What is the date today?
What is the month going on?
What is the year going on?
Which season is this?
In which country we live in?
In which place we are sitting?
On which floor we are?
MSE: Attention & Concentration (Inquired/Observed)
(Serial 7’s) “Starting with 100, subtract 7 from 100, and then keep subtracting 7 from that number as far as you can go.”
Ask the patient to tell names of week days in backward direction
MSE: Memory (Inquired)
Recent Memory
What is my name?
What medications did you take today?
What time was your appointment with me for today?
Remote Memory
B. Hallucinations, are perceived through one of the senses and do not correspond to any stimulus in the outside world. Hallucinations are defined as perceptions in a conscious mind.
8. List the nursing implications and education needs for each of the following categories of medication related to heart failure: See Attached
MMPI-A detect responses from a respondent that are inconsistent and defensive. MMPI-A can be linked with the biological approach that is characterized by chromosomes and hormone mostly in gender. Primary clinical scales of MMPI-A include depression, social introversion, and Psychopathic Deviate in line with our scenario (Berry, Wetter, Baer, Larsen, & et al, 1992). Mental Status Examination is an assessment done during the first stages of treatment. The examination diagnosis or gather information about a person psychiatric needs. Review of the school record is a systematic way of gathering the school performance information history. The review will assist in the tracing where an individual lost the mark and also the scale of the problem associated. The review of prior medical records is a way of trying to establish whether any health issue can be associated with the case or problem at hand. Interview and observation monitor the behavior of an individual towards stimuli. In a session of the interview, the interviewer listens, internalize and observes the behavior of the client. On the other end, the interviewer creates a condition for the client (stimuli) in which she is supposed to respond to. Thus the interview and observation use the behaviorist approach to obtain the information needed for assessment. Interview and
The claimant underwent a Mental Diagnostic Evaluation by George M. DeRoeck, Psy.D. on June 17, 2015. He reported to Dr. DeRoeck he was rated 70% disabled due to Post Traumatic Stress Disorder. He state he likes to watch TV in his room and fish. He also stated he avoided any reminders of violence in the media, feels tense and has flashback/intrusive thoughts about “anything burning.” Has also is iable to obtain restful sleep and is prone to lost periods of time. He began receiving outpatient treatment in 2007 via medication management and counseling at the VA. He attended inpatient treatment in July of 2013 for several months. He also attended a six-month program in October or November of 2013. At the time of the evaluation, he was going
* Hallucinations – see things that aren’t there or talk to people who aren’t around.
The Mental Health Screening Form-III (MHSF) could provide useful information to help assess the appropriate level of care according to the American Society of Addiction Medicine (ASAM). The MHSF is a versatile assessment that can be given to the client to answer or the clinician can orally give it to the client (Center for Abuse Treatment, 2005). The assessment covers a range of mental health illnesses that can prompt additional questions for the clinician to find out more information.
The Million Clinical Multiaxial Inventory III is a 175 question test based on true or false answers. It is administered in clinical settings to clients with coping and or suspected mental health issues. The purpose of this assessment tool is to assist clinicians in diagnosing mental illness and in developing appropriate treatment plans. The MCMI III will also help with treatment decisions made by clinical staff based on patterns found in personality. This test was created to discover specific Axis I (schizophrenia, depression, bipolar disorder, PTSD, ADHD, anxiety disorders, etc.) and Axis II disorders (borderline, narcissistic and antisocial personality disorders). With the help of the clinician interview, the MCMI III is a highly regarded tool for discovering some 24 personality disorders and clinical
The main purpose of the ensuing evaluation is to determine if Ms. Tyler is competent to stand trial for accused crimes, and needs to be evaluated for criminal responsibility. She exhibits signs of mental illness; further investigation via a mental status assessment is required.
31 y/o AA male patient seen today for psychiatric-mental health assessment. He is awake, alert and oriented x4. He is calm, cooperative and follows commands during assessment. The patient reports he is depressed, difficulty sleeping and nightmares at night. The patient explained his depression is as a result of deep thinking from a news he received two days ago from his elder brother that his mother is ill. Stressors identified by the patient include losing his job a week ago before the news about his mother; his wife is 6-months pregnant with their first child, who currently works part-time at her present job; patient relates difficulty paying monthly bills and inability to provide adequately for his family as a man. The patient denies mood swings, suicidal/homicidal thoughts and ideation. Patient reports his spouse is at work at the moment and he does not want to put stress on his wife due to her current condition. Patient denies been hospitalized for depression or psychiatric illness; and denies family history of mental illness. Patient reports he is seeking help because he does not like feeling this way using terms of “helpless and loss of worth from his spouse”. Patient reports he needs help with his depression and nightmares before his current condition get out of hands and ruined his marriage.
Moreover, a hallucination is not receptive to control by the individual who is experiencing it. Auditory hallucinations are among the most common. Individuals who suffer from auditory hallucinations hear sounds or voices that have no actual source (5th ed.; DSM-5). It is common that the individual initially experience the sound as coming through his or her ears. However, sometimes, the individual will eventually perceive the sound as coming from inside his or her head (Romme et al., 1992). David and Nayani (1996) claimed that individuals who suffer from auditory hallucinations may hear more than one voice. The voices can differ in content, comment on the individual’s thoughts and even have a conversation.
The human imagination is a powerful thing. After watching a horror film have you ever felt as though someone was in the room with you, even though you knew there wasn't? It’s truly fascinating what our minds can do. So fascinating that people have been studying it for years trying to understand how our minds work. These days we have professional psychologists who can explain dreams and hallucinations in very logical and scientific manners.
Hallucination: This is a perception of a sensory experience without external stimuli. It may be visual, auditory,
Hearing voices in the mind is the most common type of hallucination in people with mental health conditions such as schizophrenia. The voice can be critical, complementary or neutral, and may make potentially harmful commands or engage the person in conversation. They may give a running commentary on the person's actions. Hearing voices is a well-recognised symptom of schizophrenia, dementia or bipolar disorder, but can be unrelated to mental illness.
My client is a 25-year-old South Asian woman. She appears thin with long black hair and brown eyes. She is wearing dark pants, a long sleeved blue shirt with a multicoloured scarf. Her clothing is neat and appropriate to her environment. She is wearing makeup, appears clean and is well put together. The client answers direct questions but does not provide a lot of information. Patient is willing to provide more information when asked directly or prompted by the writer. The client’s rate of speech was slow at first but as the interview continued, became a normal rate. Her speech was clear; however spoke in a soft volume with a monotone voice. Her rhythm was smooth and her speech was not pressured. The client’s
Hallucinations are one of the most intriguing secrets of the mind, which are characterized by false visions, sounds, taste, smell, and touch that can occur when one is awake; it has a sufficient sense of reality, but one has no control over it. Hallucinations are the form of perception. There is no particular part of the brain that is involved in hallucinating. For example, people “seeing” faces could have a hyperactivity in fusiform face area involved in facial recognition. People with hyperactivity in the auditory cortex might experience auditory hallucinations: hearing music, or voices, that are not there. Hallucinations can be frightening, strange, or even amusing and divine. There are numerous causes of hallucinations: they are usually experienced by people with schizophrenia, Charles Bonnet syndrome, Parkinson’s disease, or other psychological and mental disorders. However, hallucinations can also be experienced by healthy individuals, who are the subjects for studying the nature and causes of hallucinations, as they do not interact with other symptoms like in patients with schizophrenia. Researchers use functional magnetic resonance imaging (fMRI) scans to track the brain activities during hallucinations. The aim of this research paper is to describe several types of hallucinations, ways of studying hallucinations, and possible treatments.