Mini Mental State e

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  1. Start by introducing yourself to the patient, clarify their identity and explain that you would like to talk to them about their thoughts.
  2. There are 8 components to this assessment.

    To assess appearance, behaviour and speech begin by asking some general open questions:

  3. Appearance and behaviour

    • Appearance – dress, posture, facial expression, mannerisms
    • Activity – sitting still/fidgeting
    • Social and emotional behaviour – apathy, irritable, co-operative
  4. Speech

    • Rate
    • Tone
    • Quality
    • Content – depressive ideas, delusions
  5. Now ask more specific questions relating to the other parts of the assessment:

  6. Mood

    • Symptoms of anxiety – e.g. sweating, palpitations
    • Current mood state – (both subjective and objective)
    • Any biological symptoms – e.g. sleep, appetite, libido, or loss of concentration
    • Suicidal ideation
  7. Phobias and obsessions

    • Phobias: determine the stimulus, its psychological and physiological effect and the nature of any avoidance behaviour
    • Obsessions: determine the underlying thoughts, the nature of the obsession, the effect on daily life and if it’s a senseless obsession?
  8. Abnormal experiences

    • Illusions/misperceptions
    • Hallucinations: visual, ophthalmic, auditory (second or third person)
  9. Abnormal beliefs

  10. Insight – to determine this you should ask a few directed questions.

    • What do you think is wrong with you?
    • Do you think you need any treatment?
    • What do you think the treatment will do for you?
  11. Cognition – this should be done by the mini mental state examination, although this is generally not part of the OSCE.

  12. Thank the patient for speaking to you.

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