Mental State Examination and Its Procedures—Narrative Review of Brazilian Descriptive Psychopathology
Background: Mental State Examination (MSE) is compared with physical examination as a reliable method of objective data investigation. There is a growing concern with psychiatric clinics, nosology, and the reliability of diagnostic interview methods as a source of valid diagnostic strategy. Efforts...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-03-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2019.00077/full |
| _version_ | 1818910589746937856 |
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| author | Helio Gomes Rocha Neto Carlos Eduardo Estellita-Lins José Luiz Martins Lessa Maria Tavares Cavalcanti |
| author_facet | Helio Gomes Rocha Neto Carlos Eduardo Estellita-Lins José Luiz Martins Lessa Maria Tavares Cavalcanti |
| author_sort | Helio Gomes Rocha Neto |
| collection | DOAJ |
| description | Background: Mental State Examination (MSE) is compared with physical examination as a reliable method of objective data investigation. There is a growing concern with psychiatric clinics, nosology, and the reliability of diagnostic interview methods as a source of valid diagnostic strategy. Efforts to achieve an international diagnosis protocol have been unsuccessful or polemical. This paper focuses on psychopathology, MSE, and mental function development within Brazilian psychiatry over the last few decades.Methods: Searches, interviews, and narrative reviews were done to look for systematic ways in which to conduct MSE, mental functions, symptom clusters, orientations about data observation and records. Brazilian psychopathology textbooks were examined, if they provided access to consolidated knowledge on psychopathology examination.Results: Sixteen textbooks were selected from a 49 year span. Descriptive psychopathology with phenomenological orientation was the primary trend in the MSE. Concepts derived from different traditions, most lacking common terminology, suggested some divergence among authors. Recommendations for patient observation and how to collect objective data was clear, but MSE standardization efforts were missing. A detailed description of mental function abnormalities was the main MSE record strategy, without consensus about ways to summarize and record this data. In an examination summary, mental strata was divided into “mental functions,” and MSE subsets were frequent. All authors considered the following mental functions: consciousness, perception, thought, memory, attention, orientation, and volition.Discussion: Psychiatric competence demands MSE proficiency. Official documents are not clear about performance and recording standards. MSE data was usually recorded through descriptive psychopathology. A shift from detailed descriptive findings, to an array of observed pathological elements, described through a mental function checklist was observed over time. Clinical practice and research guidelines should consider the development of reliable MSE practices; however, it has been neglected by modern psychiatry/neuroscience through the excessive emphasis on interview protocols. Better MSE practices, and the improvement of bedside skill in psychiatry are necessary and depend on the recovery of psychopathological debates and semiological reasoning, which will allow the return of phenomenology-oriented “observational” techniques. |
| first_indexed | 2024-12-19T22:45:13Z |
| format | Article |
| id | doaj.art-d0d18be3486b4eca90d870580a62b16f |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-19T22:45:13Z |
| publishDate | 2019-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-d0d18be3486b4eca90d870580a62b16f2022-12-21T20:02:57ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402019-03-011010.3389/fpsyt.2019.00077415005Mental State Examination and Its Procedures—Narrative Review of Brazilian Descriptive PsychopathologyHelio Gomes Rocha Neto0Carlos Eduardo Estellita-Lins1José Luiz Martins Lessa2Maria Tavares Cavalcanti3Centro Universitario Lusíada, São Paulo, BrazilFundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, BrazilInstituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, BrazilInstituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, BrazilBackground: Mental State Examination (MSE) is compared with physical examination as a reliable method of objective data investigation. There is a growing concern with psychiatric clinics, nosology, and the reliability of diagnostic interview methods as a source of valid diagnostic strategy. Efforts to achieve an international diagnosis protocol have been unsuccessful or polemical. This paper focuses on psychopathology, MSE, and mental function development within Brazilian psychiatry over the last few decades.Methods: Searches, interviews, and narrative reviews were done to look for systematic ways in which to conduct MSE, mental functions, symptom clusters, orientations about data observation and records. Brazilian psychopathology textbooks were examined, if they provided access to consolidated knowledge on psychopathology examination.Results: Sixteen textbooks were selected from a 49 year span. Descriptive psychopathology with phenomenological orientation was the primary trend in the MSE. Concepts derived from different traditions, most lacking common terminology, suggested some divergence among authors. Recommendations for patient observation and how to collect objective data was clear, but MSE standardization efforts were missing. A detailed description of mental function abnormalities was the main MSE record strategy, without consensus about ways to summarize and record this data. In an examination summary, mental strata was divided into “mental functions,” and MSE subsets were frequent. All authors considered the following mental functions: consciousness, perception, thought, memory, attention, orientation, and volition.Discussion: Psychiatric competence demands MSE proficiency. Official documents are not clear about performance and recording standards. MSE data was usually recorded through descriptive psychopathology. A shift from detailed descriptive findings, to an array of observed pathological elements, described through a mental function checklist was observed over time. Clinical practice and research guidelines should consider the development of reliable MSE practices; however, it has been neglected by modern psychiatry/neuroscience through the excessive emphasis on interview protocols. Better MSE practices, and the improvement of bedside skill in psychiatry are necessary and depend on the recovery of psychopathological debates and semiological reasoning, which will allow the return of phenomenology-oriented “observational” techniques.https://www.frontiersin.org/article/10.3389/fpsyt.2019.00077/fullmental state examinationpsychopathologydescriptive psychopathologyhistory of medicinepsychiatrydiagnosis |
| spellingShingle | Helio Gomes Rocha Neto Carlos Eduardo Estellita-Lins José Luiz Martins Lessa Maria Tavares Cavalcanti Mental State Examination and Its Procedures—Narrative Review of Brazilian Descriptive Psychopathology Frontiers in Psychiatry mental state examination psychopathology descriptive psychopathology history of medicine psychiatry diagnosis |
| title | Mental State Examination and Its Procedures—Narrative Review of Brazilian Descriptive Psychopathology |
| title_full | Mental State Examination and Its Procedures—Narrative Review of Brazilian Descriptive Psychopathology |
| title_fullStr | Mental State Examination and Its Procedures—Narrative Review of Brazilian Descriptive Psychopathology |
| title_full_unstemmed | Mental State Examination and Its Procedures—Narrative Review of Brazilian Descriptive Psychopathology |
| title_short | Mental State Examination and Its Procedures—Narrative Review of Brazilian Descriptive Psychopathology |
| title_sort | mental state examination and its procedures narrative review of brazilian descriptive psychopathology |
| topic | mental state examination psychopathology descriptive psychopathology history of medicine psychiatry diagnosis |
| url | https://www.frontiersin.org/article/10.3389/fpsyt.2019.00077/full |
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