Mental Health Examination Pros & Cons

Must Read Mental health examination and its essentials

Mental Health Examination is one of the most talked-about topics of this era. Everyone wants to have good Mental health. It is safe to say that everyone suffers from some sort of mental health issue at least once in their life. Sometimes, people don’t even know what’s happening with them. They continue to live with mental health issues because of a lack of diagnosis. That’s where Mental status examination proceeds to help people. Medical professionals use this technique to diagnose the underlying Mental health issue properly.

Mental Health Examination

Mental Status Examination

Mental Status Examination can be defined as the set of standard and properly structured assessment procedures that are used to observe the behavior and cognitive functioning of the patient. Mental Status Examination includes many different domains on basis of which mental status is observed and diagnosis is made.

The purpose behind Mental Status Examination, also called MSE is to collect cross-sectional information regarding the mental status of the patient. This information then is combined with the biographical and historical information on the psychiatric history of the patient to draw on accurate diagnosis and treatment plan accordingly.

One thing to be kept in mind is that MMSE is different from MSE. Though MMSE is a part of MSE, still MMSE is a mini test used for the diagnosis of dementia. MSE is a broader test and it may include MMSE in it. MSE helps in diagnosis among different mental health issues.

Mental Health Examination

Complete dataset and information of a patient are collected during the interview by the doctor. This information is based on the observation of the doctor during the interview. It extracts any sort of sign or symptom of any possible mental health issue. It may even signal danger to self etc. Many domains are assessed or observed by the doctor. Let us discuss all those domains one by one: –

Appearance

The first thing that anyone observes in an interview is your appearance. Surprisingly, this is also the first thing during the MSE that a doctor is going to notice. Examiner notices the physical appearance of the patient, age, weight, height, dressing manner, etc. If the patient looks much older than his actual age, this is a big sign that suggests poor self-care.

Some physical features may point towards malnutrition, alcoholism, or substance abuse by the patient. The odor that the patient exhibit may also tell a lot about his/her personal hygiene. Weight Loss also draws on to disorders like depression, anorexia, physical illness, or anxiety.

Mental Health Examination

Attitude

Attitude can be defined by the level of cooperation the patient is willing to show towards the whole process. It is seen as the approach exhibited by the patient towards the examiner and the whole interview process. A patient may not be willing to cooperate and may not answer accurately. This makes it difficult for examiners to obtain information from people exhibiting negative attitudes. It also affects the overall quality of the process and the data collected throughout the assessment.

Mental Health Examination

Behavior

Throughout the assessment, the patient’s behavior is another thing observed by the examiner. Any sort of abnormality in a patient’s behavior may include abnormal movements, observation of patient’s eye contact, and observation of the patient’s arousal on different statements.

Some abnormal movements like athetoid may suggest some sort of neurological disorder while a tremor may be an indication of some underlying neurological condition or side effects of medicines. Tics may suggest Tourette’s syndrome while repetitive purposeful movements or abnormal movements may indicate be a sign of autism or schizophrenia.

A person may reflect symptoms of akathisia by being unable to sit still. The decrease in arousal or movement can be indicative of depression, Parkinson’s, dementia, and even delirium. Eye contact also conveys sensitive details, and an absence of eye contact can relate to illnesses such as depression or autism.

Mental Health Examination

Mood

There is some sort of disagreement in the differentiation of Mood from Affect in MSE. Usually, Mood is said to be described by the patient’s own words. Patients give a summary of their moods. They may use different terms like neutral, anxious, angry, euphoric, etc.

It is completely possible that a person may not be able to define their mood subjectively and such individuals seem to suffer from Alexithymic. Anhedonia is a condition in which some people find it difficult, if not impossible, to enjoy any form of pleasure.

Mental Health Examination

Affect

Mood and Affect are used together many times. But we believe these two are different terms. Affect can be defined as the observations made by the examiner on the non-verbal behavior of a patient like his/her anxiety level, sadness, etc. Affect depicts the underlying state of the person.

Some parameters are used to conclude the effect. These parameters include mobility, reactivity, appropriateness, range, and intensity, etc. These parameters can help to define effect as appropriate and inappropriate. Sometimes, a person may stay bland while having a conversation on a really disturbing topic, it could be an indication of schizophrenia.

The intensity of the effect exhibited by the person can be explained as dramatic, bland, blunt, exaggerated, etc. If a person exhibits a flat effect, this suggests depression, schizophrenia, and some sort of stress disorder. If the affect is very dramatic, then it means a person may have personality disorders.

Mental Health Examination

Speech

Speech observations are also used to conclude a diagnosis of the mental health issues. Assessment of Speech functions of a patient is performed by the observation of the patient’s spontaneous speech. It may include some properly designed tests on the specific language functions. Examiner will observe spontaneous speech features like loudness, rhythm, pitch, latency, quantity rate, etc.

Studies show that speech functions are highly disturbed I mental issues. So any change in spontaneous speech functions may help in better diagnosis. Examiner may ask the patient to perform some activities like repeating certain words or naming specific objects, etc.

These assessments may help to recognize mental conditions like dementia, aphasia, mutism, etc. Depressed patients may take time to respond and anxious patients may produce sudden and haphazard responses. Schizophrenia patients may make up some words on their own. While patients with dementia may forget some words while speaking.

Mental Health Examination

Thought process

It is one of the most essential parts of MSE. It indicates the quantity, rate, and form of thoughts in the patient’s mind. Observing the Thought process is indeed difficult as you can not read someone’s mind. It can only be observed or interpreted from the patient’s speech.

While interviewing, some person may get a flight of ideas that could depict a maniac symptom. Their thought process will be fast but their words may seem disrupted and broken. On the other hand, some people may experience a downfall in the number of ideas which can be the main feature of dementia and depression.

Patients with dementia have a small circle of thoughts that they may keep returning to. Patients with personality disorders or anxiety issues may exhibit circumstantial thinking.

Mental Health Examination

Thought content

It is not enough to just observe thought processes. Description of thought content is another large part of the mental status examination. It collects information on the patient’s suicidal thoughts, Phobias, overvalued ideas, Obsessions, and Delusions, etc.

Delusion can be indicative of many issues like schizophrenia, mania, depression, etc. Overvalued ideas can throw light on some excessive beliefs of people on wrong facts like anorexia nervosa, where a person’s thinking is surrounded by their weight. Unnecessary and unhealthy Obsessions may lead to Obsessive-compulsive disorders.

Mental Health Examination

Perceptions

Perception is the next domain in MSE. Perceptions are referred to as any sort of sensory experience. There can be disturbances in Perceptions and it has 3 main types. These types are hallucinations, pseudohallucinations, and illusions.

During hallucinations, a person may experience things that he considers to be real, but the reality is quite opposite. No external stimulus is available in hallucinations. While illusions are referred to as wrong perceptions in the availability of any external stimulus. Whereas, Pseudohallucinations may be experienced internally in the subjective space. Someone may describe Pseudohallucinations as in the form of some voices in their head.

Mental Health Examination

Cognition

Cognition may be regarded as the level of alertness, attention, memory, orientation, and language functions exhibited by the patient. To check the Cognition in a patient, a combination of structured tests and random observations are used.

Alertness can be seen as the rate of consciousness in a patient. Orientation is observed by asking a series of questions like where does he live, what time of the day it is etc. Serial seven tests are used to measure the attention and concentration level of a patient. By observing drawing abilities, visuospatial functioning can be tested out. Cognitive abilities can help to rule out many mental issues and select the right diagnosis.

 

Mental Health Examination

Judgment

The last part or dimension of MSE is judgment. Here the ability of judgment by the patient is observed. Judgment is said to be the ability of the patient to make responsible, mature, sound, and logical decisions. The judgment of a person can be normal and it may seem to be impaired.

Scenario-based questions are asked like what would you do if you find a bag lost in the street that has all the necessary information of the owner. Nowadays, more of the real-life practices of the patients are held into observation. Through these observations, results are drawn if the judgment of the patient is impaired or not.

Surprisingly, impaired judgment may not point directly to any related disorders. But it can show symptoms of any damage to the frontal lobe of the brain. If a patient’s judgment is impaired, it is a serious safety concern for himself along with the people around the patient.

Mental Health Examination

Conclusion:

It is true that many people suffer from mental health issues and become confused while trying to get the right diagnosis by themselves. That’s why it is important to visit a psychiatrist, have a talk with the psychiatrist and take the necessary test to get the right diagnosis and right treatment accordingly.

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