Mental Status Examination

It is an evaluation of a person’s status of cognitive skills, capacity, emotional mood, thoughts, patterns of using language in a given time period. This central nervous system assessment contains observation of behaviors and attitudes of a person by the examiner.

The most frequently used method was developed in 1975 called Folstein Mini Mental Status Examination.

What is the role of Mental Status Examination in schizophrenia?

Mental Status Examinations is a critical assessment to find out the level and the existence of a mental disease for a patient. In this examination, patient’s cognitive functions are being measured. The measurement includes person’s ability to talk, intellectual capacity, mathematical skills, problem solving abilities, personal sensations about the time, place and the personal identity. The role of mental status examination also relies on the ability to make differential diagnosis. It is important to diagnose patients who are suffering from dementia other than people who are experiencing other psychiatric diseases. Besides differential diagnosis, mental status examination may be used to monitor a patient’s current status from time to time.

Mental Status Examination (MSE) helps clinicians formally assess and record a patient’s behavior according to a number of specific categories. The following categories are most relevant in diagnosing schizophrenia:

• general description: The general appearance of patients with schizophrenia can range from being disheveled and agitated, to being well-groomed and silent, to being physically rigid (catatonic) or immobile. In general, however, people with schizophrenia are often poorly groomed, have not bathed recently, and may dress too warmly for the current weather conditions.
• mood, feelings, and affect: As many as 25% of people with schizophrenia experience depression following a psychotic episode. Patients often also display moods or emotions suggesting confusion, terror, a sense of isolation, and overwhelming ambivalence.
• perceptual disturbances: In addition to auditory hallucinations, people with schizophrenia may experience cenesthetic hallucinations, which are false sensations in organs of the body. For example, a person might feel a burning sensation in the brain, a crawling sensation in the blood vessels, or a liquid sensation in the bones.
• thought: Some patients may have a “loss of ego boundaries,” which is the a lack of a clear sense of where the patient’s own body and mind end and where those of other people or objects begin. Other sensations may include fusing with an outside object or having disintegrated into the universe.
• impulsiveness and violence: People with schizophrenia who are agitated may have little impulse control and may behave unexpectedly. For example, they may suddenly grab another person’s personal belongings such as a purse, book, or food item, change television channels abruptly, or throw an object across the room. The impulsive behavior may also be dangerous, including attempted suicide or homicide, possibly in response to a command from hallucinatory voices.
• orientation: Although some people with schizophrenia are oriented to person, time, and place, some may give incorrect or bizarre answers to questions about these aspects of orientation. For example, when asked his or her name, a person might respond, "I am the Prophet Mohammed, and I am heading into battle tomorrow morning, at the turn of the 8th century."
• judgment and insight: People with schizophrenia often have poor insight into the nature and severity of their disorder. Lack of judgment or insight may also be seen as deficits in other areas of functioning, such as difficulty getting along with people.