What Is...the Mental Status Exam?

December 18, 2011

Author: Catherine M. Callery (Kate)| Louise M. Tarantino

The mental status exam (MSE) is the cornerstone in the evaluation of any patient presenting with a medical, neurologic or psychiatric disorder that affects thought, emotion or behavior.  The exam is also important in assessing changes in thought processes caused by use of medication.
 
The MSE involves the systematic assessment of a patient's function through consideration of several factors including, 1) appearance, which can provide information about social judgment or the ability to tend to basic needs (e.g. dirty or disheveled), 2) social interaction, i.e. the nature and quality of the patient's interaction with the interviewer or family members, 3) orientation to time and place, 4) appropriateness of behavior, 5) affect, or emotional tone as inferred by the tester, 6) mood, or the patient's report of his emotional state, 7) use of spoken and unspoken language (e.g. pressured speech, flight of ideas, speech retardation, dysphasias), 8) attention and concentration, tested by serial 7s, 9) short and long-term memory, 10) ability to perform calculations and make abstractions, 11) ability to reproduce geometric figures, 12) thought content (e.g., delusions?), 13) perception in all five senses (e.g., hallucinations?), 14) social and moral judgment, and 15) degree of impulse control, especially pertaining to the potential for harming oneself or others.

The elements of the MSE are designed to identify and characterize abnormalities typically observed in patients with either a functional disorder or an organic disorder.  A trainer interviewer can generally assess the mental status of a patient in about 15 minutes.  A written summary of the MSE generally addresses  only those points essential to the deliver of care to the patient.
 
For more information on the MSE, see http://www.psychpage.com/learning/library/assess/mse.htm, and http://emedicine.medscape.com/article/293402-overview.