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UK MENTAL STATE EXAMINATION

Appearance and behaviour Speech Thought Mood and Affect Abnormal perceptions Cognition Insight

-description -rate, tone, spontaneity, flow -content, form, suicidal? -objective & subjective -hallucinations/ delusions -Mini-Mental State Examination -about disease/ treatment

Depression
Poor eye contact Looks sad Upset Crying or tearful Unkempt Loose clothes -? Weight loss

Mania
Hyperkinetic Inappropriate clothes (ie wearing not much in cold weather) Pacing around Difficulty sitting down to talk High

Paranoid Schizophrenia
May be normal Restlessness or agitated Mannerisms (purposeful movements for no reason e.g. saluting) Stereotypies (repetitive unpurposeful movements e.g. rocking or grimacing) Catatonic signs frozen like statue Poor personal hygiene Unkempt clothing

Appearance and Behaviour

Speech

Slow Difficult to start conversation with Mono-tone voice Reduced volume Reluctant to speak Usually comprehensible

Pressured Difficulty interrupting Fast speech Change topics quickly Flight of ideas Difficult to follow conversation

Speech itself is often normal Knight move thinking Loosening of associations Neologisms (made-up or inappropriate word)

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Depression
Objective looks depressed Inappropriate Affect if severe may not reaction to any situations appropriately

Mania
Subjective no problem Objective a bit over the top/ manic/ irritable

Paranoid Schizophrenia
Blunted affect no expression of emotion or change in mood with emotion Or inappropriate affect (e.g. giggle when talking about something serious)

Mood

Thoughts

Worthlessness Hopelessness Suicidal thoughts Delusions if severe (depression with psychotic symptoms) Persecutory delusions

Ideas of deliberate self harm Ideas of harming others esp. if they feel you want to stop them doing things Grandious delusions (special powers)

Delusions totally bizarre and unrealistic (e.g. from different planet) or possession of thought delusions Grandiose, religious and persecutory delusions are also common

Abnormal Perceptions

Auditory hallucinations if severe 2nd person, sounds exactly like hearing people talking Usually normal May have poor memory due to poor concentration and to inattention

Auditory hallucinations 2nd person

Auditory hallucinations 3rd person/ thought echo/ running commentary

Cognitive State

Usually normal

Usually normal Deficits in concentration and abstract thought may be found in patients who are acutely psychotic or who have chronic negative symptoms