Affect | Mental Status Exam - MedSchool
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Mental Status Exam
 
 
Mental Status Exam
Affect is the immediate expression of emotion, and can be used to objectively assess a patient's mood. Affect can be assessed by covering a wide range of topics through the course of the conversation. Enquire about personal losses as well as loved ones and achievements.
Appearance
Behaviour
Affect & Mood
Cognition
Speech
Thought
Perception
Insight & Judgement
 

Affect

 
 
On this page:
Range of Affect
Appropriateness of Affect
Intensity of Affect
Stability of Affect

Overview

  • Affect is the immediate expression of emotion, and can be used to objectively assess a patient's mood. 
  • Affect can be assessed by covering a wide range of topics through the course of the conversation. Enquire about personal losses as well as loved ones and achievements.
  • Flattened affect: limited range of emotion, but not to the point of apathy.Mild to moderate depression
  • Blunted affect: apathy, decreased intensity and small-ranged affect. The patient does not express happiness or sadness and has no depth of conviction.Chronic schizophrenia, severe depression
  • Blunted and flattened affect are often used interchangeably.

Range of Affect

  • Restricted: a spectrum of emotions is not elicitable.Depression, schizophrenia, antisocial personality disorder
  • Expanded: excessive joy, sadness or irritability.Mania

Appropriateness of Affect

  • Appropriate: correlation between the content of speech and the accompanying emotional expression.
  • Inappropriate: lack of correlation between the content of speech and the accompanying emotional expression. The patient may laugh while discussing depression or cry while claiming to be happy.
  • Incongruous: lack of correlation between affect and stated mood. The patient may claim to be depressed but without flattened affect, e.g. laughs at jokes.
  • Fatuous: inappropriate affect that is overly childlike.Associated with hebephrenia, but may indicate an intellectual disability or represent an inappropriate coping mechanism e.g. in an eating disorder.

Intensity of Affect

  • Increased: intense emotional expression with inflexibility in convictions, which may be accompanied by abusive statements.Bipolar affective disorder, cyclothymia, borderline personality disorder
  • Normal: appropriate intensity of emotional response.
  • Decreased: apparent shallowness with little conviction behind responses. A feature of flattened or blunted affect.Depression or schizophrenia

Stability of Affect

  • Stable: changes in mood that are relevant to the flow of conversation.
  • Labile: frequent shifts in emotional expression.
  • Emotional incontinence: extreme lability.
Last updated on November 7th, 2019
 
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