Mood and Affect

Affect is the patient's immediate expression of emotion. Patients display a range of affect that
may be described as broad, restricted, labile, or flat. Affect is inappropriate when there is no
consonance between what the patient is experiencing or describing and the emotion he is
showing at the same time (e.g., laughing when relating the recent death of a loved one). Affect
must be judged in the context of the setting and those observations that have gone before. For
example, the startled-looking patient with eyes wide open and perspiration beading out on the
forehead is soon recognized as someone suffering from Parkinson's disease.

Affect is any experience of feeling or emotion, ranging from suffering to elation, from the
simplest to the most complex sensations of feeling, and from the most normal to the most
pathological emotional reactions. Patients display a range of affect that may be described as
broad, restricted, labile, or flat. Affect is inappropriate when there is no consonance between
what the patient is experiencing or describing and the emotion he is showing at the same time
(e.g., laughing when relating the recent death of a loved one).

Questions for assessing affect:-

This is assessed through posture, movements, body, facial expressions and tone of voice.
You do not ask any questions in this section; it's purely observational.
Descriptors include:
• Intensity: Normal, blunted, flat?
• Quality: Sad, agitated, hostile?
• Fluctuation: Labile- easily altered?
• Range: Restricted, expansive, normal?
• Congruence: Congruent / incongruent

Mood can be defined as a pervasive and sustained emotion or feeling tone that influences a
person’s behavior and colors his or her perception of being in the world. Disorders of
mood—consisting of depressive disorder, bipolar disorder, and other disorders.

It is a disposition to respond emotionally in a particular way that may last for hours, days, or
even weeks, perhaps at a low level and without the person knowing what prompted the state.
Moods differ from emotions in lacking an object; for example, the emotion of anger can be
aroused by an insult, but an angry mood may arise when one does not know what one is angry
about or what elicited the anger. Disturbances in mood are characteristic of mood disorders.
Mood refers to the more sustained emotional makeup of the patient's personality.
Both affect and mood can be described as dysphoric (depression, anxiety, guilt), euthymic
(normal), or euphoric (implying a pathologically elevated sense of well-being).

Questions for assessing mood:-

Objective How we observe and describe their mood):
• Elated, dysthymic, euthymic, apathetic, blunted, depression (mild/moderate/severe), irritability,
anxious?
• Does their mood change throughout the meeting?
• What is the constancy of mood?

Subjective (As reported by the patient and observed by the examiner

Ask the patient to describe how they are feeling and if they are experiencing any biological
symptoms as a result of their mood-for example, insomnia or appetite.
Make sure you note their exact words and verbatim. Example questions to encourage a
subjective answer:
- How have you been feeling recently?
- How have your energy levels been?
- Have you been sleeping and eating well?
- Have you felt irritable, angry, depressed, discouraged or unmotivated recently?

References

American Psychological Association. (n.d.). Apa Dictionary of Psychology. American

Psychological Association. Retrieved January 9, 2023, from https://dictionary.apa.org/mood

Manjunatha, N., Khess, C. R. J., & Ram, D. (2009). The conceptualization of terms: 'mood'
and 'affect' in academic trainees of Mental Health. Indian journal of psychiatry. Retrieved
January 9, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802377/

The mental status examination - clinical methods - NCBI bookshelf. (n.d.). Retrieved January 8,
2023, from https://www.ncbi.nlm.nih.gov/books/NBK320/

Ten point guide to mental state examination (MSE) in psychiatry. Psych Scene Hub. (2022, June
24). Retrieved January 9, 2023, from
https://psychscenehub.com/psychinsights/ten-point-guide-to-mental-state-examination-mse-in-ps
ychiatry/