ABSTRACT
This chapter presents a case of a 42-year-old woman who comes into hospital for a laparoscopic cholecystectomy. The admitting doctor has concerns about her mental state. There are concerns about whether she is healthy enough to cope with an operation and the recovery from it. The doctor takes a psychiatric history. The mental state examination is equivalent to the physical examination in medicine or surgery, but a different system is being examined. It takes place through observation and through probing questions designed to elicit psychopathology. It is structured and follows a procedure. It is put together with the history and investigations. The mental state examination contributes to the formulation, which is a summary of the mental health problems and their relation to other aspects of life. Formulation includes a diagnosis and may include a multi-axial diagnostic understanding. Formulation uses information from the history and mental state examination to describe the three Ps: predisposing factors, precipitating factors and perpetuating factors.
