What data are recorded regarding patient reliability during a Mental Status Examination (MSE)?

Updated: Sep 24, 2020
  • Author: Jeffrey S Forrest, MD; Chief Editor: David Bienenfeld, MD  more...
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Answer

Answer

estimate the patient's intelligence quotient (ie, below average, average, above average).

Insight

Assess the patients' understanding of their condition. 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. A patient's attitude toward the clinician and the illness plays an important part to developing insight into their condition and overall prognosis.

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").

Impulsivity

Estimate the degree of the patient's impulse control. Ask the patient about doing things without thinking or planning. Positive responses may result in follow-up questions about the frequency of which impulsive behaviors occur and whether they appear to impact a patient’s functioning (eg, punching walls in anger, destroying property, getting into verbal altercations, or experiencing black-out anger).

Reliability

Estimate the patient's reliability. Determine if the patient seems reliable, unreliable, or if it is difficult to determine. This determination requires collateral information of an accurate assessment, diagnosis, and treatment.


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