Mental status examination in survivor of Gender Based Violence and sexual violence

Mental status examination in survivor of Gender Based Violence and sexual violence.

Topics to be discussed... What is MSE ? Importance in medico- legal cases Headings of MSE and how to proceed...

What is MSE ?. Mental status examination- structured way of observing and describing a patients current state of mind. Aims of MSE : To elicit objective and subjective information Objective - what you observe in patient during interview Appearance, behavior, speech, cognition and mood Subjective - what Is patients current psychological symptoms Mood, thoughts, perception and insight.

Importance of MSE in MLE. Helps to i dentify the presence and severity of a variety of mental health conditions And the risk a patient poses to him- or herself, or to others . Purpose is to reach a tentat ive diagnosis Assess cerebral func tions and detect abnormal functions..

General appearance and behavior. Training for clinical medico-legal examination and report preparation for medical officers and other medico-legal examiners.

Speech. 2- SPEECH Rate and quantity of speech oVVhether speech is present or absent ( rnutis rn) olf prese nt. •..vhether it is spontaneous. oProd uctivity is increased or decreased. o Rate is rapid or slove oP recsure of speech or poverty of speech. urn e and tone of speech 01 n cre a s ed/ decrea s ed..

Mood and affect. MSE — Mood & Affect Quality Euphoric Mood Fluctuations Depressed Mood Labile Mood — Excessive Variation in mood without apparent reason ( Seen in Mania) Affective Flattening — Absence Of mood change irrespective Of situation (Seen in Schizophrenia) & Congruency Appropriateness of affect is described in relation to social situation Congruency Of mood is described in relation to the thought content Of the person Alexythyrnia — Inability to understand ernotions of others or express emotions of self Anhedonia — Loss Of capacity to experience pleasure [unable to enjoy anything in lifel With From.

Thought. the v-vay vvhich a pelts ideas and associations- —goal—directed thinking Loosening Of associations or —Flight of ideas — T rmtial it-y — Circurnstantiality — VVc»rc1 salad or — Neologisrns Clang associations C rhynming) — rneaning) —Thought blocking —Vague thought together a persorm is actema11y thilXkirxg about- ExalX1p1 e s : — E)elusions Preoccupations —Obsessions and conupulsions Phobias — S Eliciclal or ideas —Ideas of reference and influence — Poxrert-y of.

Perception. Perception Perception is receiving information using one Of the sensory modalities ed Illusion False Perception Hallucinations False Perception of a Real Object Psuedo-hallucinations Experienced in inner subjective space or 3 originating within the mind. D/F — Recognized as UNREAL by patient With In absence of object or stimulus Are Vivid [Clear or detailed I Experienced in Outer Space Not Under Willful Control From www.med icoapps.org.

Higher mental function. 8)) COGNOTOON AN AWARENESS OF SELF AN ENVIRONMENT. ASSESSING HIGHER CORTICAL FUNCTIONING. 1- ORIENTATION: TIME, PERSON, AND PLACE 2- CLOUDING OF CONSCIOUSNESS: A STATE OF DROWSINESS/ MEMORY IMPAIRMENT/ THINKING/ CONCENTRATION. 3- STUPOR: STATE WHERE THE INDIVIDUAL IS MUTE, IMMOBILE OR UNRESPONSIV 4- MEMORY: ASSESS IMMEDIATE. RECENT AND LONG-TERM MEMORY 5- VISUOSPATIAL FUNCTIONING: ABILITY TO IDENTIFY VISUAL AND SPATIAL RELATIONSHIP AMONG OBJECTS. DRAW A CLOCK SHOWING -11:10. BE MINDFUL THAT GENERAL KNOWLEDGE CAN VARY DEPENDING ON CULTURE/ETHNICITY. MMSE/MQCA FOR FURTHER DETAILED COGNITIVE TESTING-.

Judgement. 7- JIJDGEUENT + Social is observed during the tx»spital stay and the interview session. is assessed bv asking the what he wou'd do in certain situations, like •a house on fire'. or •a roan on the road'. or •a sealed, stamped. addressed envelope lying on a street'. O Judgment is rate d as or.

Insight. Training for clinical medico-legal examination and report preparation for medical officers and other medico-legal examiners.

WOY,. Conclusion. MSE is as important as physical examination in medicine Helps to determine the psychological problem in the survivor of gender based violence and sexual violence.

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