MSE PCL 11

Appearance

Observe the person's self-care, grooming, general physical health and dress. For example, a man who is depressed may neglect his self-care. A person with schizophrenia may dress bizarrely. A person with obsessive - compulsive personality traits may dress with excessive conformity, while one with histrionic traits may dress flamboyantly.

Behaviour

Note how the person acts during the interview. A depressed person may exhibit psychomotor agitation or retardation. An anxious person may sweat, have a tremor and startle easily.

Conversation

Document the volume and rate of speech, and the command of grammar and vocabulary.

Mood/affect

Mood refers to the sustained emotional tone that is reported by the individual. Some words commonly used to describe mood include euthymic, depressed, angry, elated, elevated, irritable or anxious. Affect refers to the varying emotional response witnessed during the interview. Some terms used to describe this include appropriate, inappropriate, fatuous, blunted, restricted, flat or labile.

Thought process

Record the patient's thought process information. The process of thoughts can be described with the following terms: looseness of association (irrelevance), flight of ideas (change topics), racing (rapid thoughts), tangential (departure from topic with no return), circumstantial (being vague, ie, "beating around the bush"), word salad (nonsensical responses, ie, jabberwocky), derailment (extreme irrelevance), neologism (creating new words), clanging (rhyming words), punning (talking in riddles), thought blocking (speech is halted), and poverty (limited content).


Cognition

Involves several areas of thinking such as level of consciousness, orientation, concentration and attention span, as well as memory.

Judgment

Estimate the patient's judgment based on the history or on an imaginary scenario. To elicit responses that evaluate a patient's judgment adequately, ask the following question. "What would you do if you smelled smoke in a crowded theater?" (good response is "call 911" or "get help"; poor response is "do nothing" or "light a cigarette").

Insight

Assess the patients' understanding of the illness. To assess patients' insight to their illness, the interviewer may ask patients if they need help or if they believe their feelings or conditions are normal.