What Is the Mental Status Examination?

A mental status examination (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 appears initially and while providing answers to questions about symptoms. The patient’s current state of mind is determined based on how he or she appears, behaves, and what type of attitude he or she exhibits. Mood, speech, and aspects of thought are also gauged.

In order to properly diagnose mental problems, psychiatrists have to rely on more than a patient’s psychiatric history. Unlike a mini-mental state examination that quickly screens for dementia, a mental status examination is more detailed. It combines psychological tests to determine symptoms a patient with a psychiatric history experiences. The goal is to gather as much information as possible to obtain the correct diagnosis for proper treatment.

One of the first aspects of a mental status examination a psychiatrist must gauge is the patient’s physical appearance. Weight, age, and height are determined, and certain types of appearance can suggest different mental issues. Odd or bright clothing choices can suggest the patient suffers from mania, while dirty or frazzled clothing can suggest depression. Patients who exhibit uncharacteristic changes in their appearance may suffer from a personality disorder, and signs of addiction suggest that the patient may be trying to self-medicate to deal with mental issues.

The patient’s attitude during a mental status examination is another aspect that psychiatrists observe. Each patient’s circumstances affect his or her attitude toward the clinical assessment and the clinician performing the examination. Patients can be cooperative, uncooperative, and even hostile. Psychiatrists can use these reactions to determine what the diagnosis may be.

A mental status examination also assesses the mood, speech, and aspects of thought a patient has. Mood is determined by how a patient reacts and how he or she answers questions about symptoms. Based on these criteria, a psychiatrist can factor in the current mood of the patient with his or her symptoms to make a diagnosis. For example, a patient who cannot describe a mood in his or her own words may suffer from alexithymia.

Thought process and content are important aspects of a mental state examination. Psychiatrists need to understand how a person processes information and exactly what his or her thought processes involve. More specifically, psychiatrists look for the occurrence of delusions, phobias, and obsessions. Additionally, the intensity of the content is important. The intensity plays a large role in determining the severity of a mental issue.