Mental State Examination appearance and behaviour

General appearance and

The mental state examination is an essential part of every psychiatric initial interview. It is sometimes regarded as the equivalent of the physician or surgeon's physical examination (although the physical exam is also part of the psychiatric work-up). In the mental state exam, the psychiatrist can exercise greater objectivity than is possible in the history alone. At times, an unco-operative patient can still have their mental state examined.


  • General appearance and behaviour
Describe the dress, posture and general appearance of the patient. What picks out this patient from the crowd? Accent, rate, rhythm and volume. Was it spontaneous?
  • Mood (subjectively and objectively)
What did the patient say their mood is like? Does this match with our impression? Any blunting of the affect?
  • Thoughts (form and content).
Include suicidal thoughts and intent. Delusions, passivity phenomena are recorded here. This involves hallucinations of whatever modality
  • Cognition (orientation, memory)
Best tested formally, as it is easy to wrongly assume a perfectly intact cogniotion in a patient with good social skills. Includes acceptance of illness (if present) and willingness to pursue treatment. Sometimes considered as part of the history, but should include interests, coping style and quality of relationships.

Sample of how a mental state examination might be recorded

  • General appearance: dishevelled, with dirty clothing and hair. Holding head in hands. Minimal eye contact.
  • Speech: Very quiet. Monotonous. Small amount. Minimal spontaneity.
  • Mood: Subjectively and objectively low.
  • Thoughts: Automatic negative thinking observed. Feelings of guilt and worthlessness readily apparent. However, denies any suicidal ideas or thoughts of self harm at the present moment.
  • Perceptions: 2nd person auditory hallucinations since one week.
  • Cognition: Intact. MMSE 29/30.
  • Insight: Limited acceptance of need to be in hospital. Is compliant with medication.
  • Premorbid personality: according to his wife, he is an introvert, but very friendly and approachable except in times of crisis.

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What is the Mini Mental State Examination (MMSE)?

The Mini Mental State Examination (MMSE) is the most commonly used test for complaints of memory problems or when a diagnosis of dementia is being considered and is carried out by a medical professional.

My rapist if free because the hospital refused to examine me due to mental state. What do i do? | Yahoo Answers

You admit that you were in a mentally disturbed manic state. The authorities had to deal with you at face value that you were a danger to yourself and/or others. After they determined anything else was going on, other actions should have been taken.
I have a sense that you are leaving out a part of the story. If all you said is accurate and they were aware of the underwear, they should have taken a report. Why the heck would anyone give you back a knife you were threatening yourself with after psych treatment??! Something ain't right with this question. Go and report now and take the …

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