Mental status examination

Abstract

The mental status examination (MSE) is an interview screening evaluation of all the important areas of a patient's current emotional and cognitive functioning, often augmented with some simple cognitive tests. The MSE provides the data for formulating a psychiatric diagnosis or developing a working hypothesis regarding psychiatric diagnosis. The MSE is to psychiatric diagnosis what the physical examination is to medical diagnosis (Scheiber, 2004; Robinson, 2001). The MSE also can be used as a basis for developing diagnosis of neurobehavioral disorders because of neurological damage, but this chapter will focus on the psychiatric application of the MSE. Interested readers are referred to Strub and Black's (2000) seminal work on use of the MSE for a neurologically oriented diagnosis. The MSE is based on observations of the patient's nonverbal and verbal behavior and includes the patient's descriptions of her subjective experiences. Evaluation of a person's emotional and cognitive state by means of interview observations can be subjective. Subjective impressions can lead to an unreliable diagnosis. The purpose of the MSE is to provide a framework for the comprehensive evaluation of mental functioning that increases objectivity and reliability of the data and subsequent diagnosis. There is a high degree of similarity between various MSE formats presented in the literature, suggesting there is a relatively good consensus about what comprises a standard MSE. It is thus important to develop a standardized approach for conducting an MSE that includes assessment of the domains described below. A standardized approach increases reliability of the MSE - that is, the likelihood that the patient would be diagnosed the same way by another professional using an MSE (Daniel & Crider, 2003; Scheiber, 2004). A standardized approach facilitates communication about the patient and makes it easier to identify changes in the patient. It aids in assessing the severity of the patient's problems by establishing a standard of comparison across patients (Schogt & Rewilak, 2007). © 2010 Springer-Verlag US.