Mini Mental Status Exam for Depression
Findings in the MMSE or AMT may prompt the clinician to do further screening and testing. One of these tests may be the Mental Status Examination (MSE), which is more comprehensive than the MMSE or AMT. The following table compares delirium, dementia and depression and the indications that may be found during a MSE.
| Examination item | Dementia | Depression | Delirium |
|---|---|---|---|
| General appearance | Varies according to severity of symptoms and assistance with ADLs | ||
| Behaviour | Variable | Possible psychomotor retardation or agitation | Restlessness, picking at clothes or bedclothes |
| Affect | Flat, apathetic, may be irritable | Depressed, tearful, apathetic, irritable |
May be tearful, giggly, and anxious May fluctuate |
| Thought stream | May be normal, depends on degree of impairment | Normal to slow |
Not fluent Fluctuating |
| Thought form | Varies and depends on degree of impairment | Usually normal. Perhaps some “blocking” | Thought disorder |
| Thought content | Poverty of thought and content | Hopelessness, helplessness, guilt, poverty, emptiness, unworthiness or paranoia. There may be suicidal ideas or intent. Possible mood-congruent delusions or somatic complaints such as constipation or contamination. | There may be delusional beliefs, paranoia, grandiose or depressive and negative thoughts |
| Perception | Occasional hallucinatory experiences (usually auditory). May have periods of misidentification | Occasional hallucinatory experiences that are congruent with the depressive thought processes. |
Frequent florid and bizarre hallucinations |
| Cognition | Varying degrees of Impairment dependant on severity | Disordered | May be impaired dependant on severity |
| Attention and concentration | Usually intact | May be poor but can be engaged | Very poor |
| Orientation | Poor | Usually unaffected but may be uninterested | Absent |
| Short term memory | Usually intact but may not want to be bothered | Absent or fluctuates | |
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