Types of Mental Status Examinations
Brief Screening Mental Status Examination
When a patient has been referred to an ambulatory clinic for a situational or personality problem, and none of the indications for a comprehensive screening examination pertain (see next section), a brief, informal screen is sufficient. The brief screening MSE is completed during the inception, reconnaissance, and detailed inquiry stages of the psychiatric interview.
In particular, the interviewer notes the patient’s general appearance, motor behavior, quality of speech, relationship to the interviewer, and mood. From the patient’s demeanor, conversation, and history, the interviewer makes inferences about consciousness, orientation, attention, grasp, memory, fund of information, general intellectual level, language competence, and thought process. Abnormal thought content is not investigated unless clinica1 clues indicate the need for such discretionary inquiry (eg, into hallucinations, obsessions, depersonalization). Physiologic function (eg, sleep, appetite, libido, menstrual cycle, energy level) and insight should always be assessed.
Comprehensive Screening Mental Status Examination
The interviewer should be alerted to the need for a comprehensive screening MSE whenever there is a reasonable possibility that the patient has psychosis or primary or secondary brain dysfunction. Table 8-3 summarizes the settings and clues that mandate a comprehensive MSE. If the clinician has any doubts, the comprehensive screen should be completed.