Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Letter to the Editor Psychopathology 2008;41:336–337 DOI: 10.1159/000146072 Assessment of Mood and Affect by Mental State Examination in Different Cultural Contexts N. Manjunatha S. Saddichha B.N.P. Sinha C.R.J. Khess Central Institute of Psychiatry, Kanke, Ranchi, India Serby [11] reported a study on New York psychiatry trainees (n = 99) concern- ing the conceptualization of mood and af- fect. In this context, we decided to com- pare the responses to similar sets of ques- tions in the Central Institute of Psychiatry (CIP), Ranchi, India, with some modifica- tion by adding 4 more items of the sign/ symptom dimension and including 1 more response, ‘not sure’, to the existing ‘true’ and ‘false’ choices for each item. Terms/ phrases which were deemed ambiguous were rephrased with consensus. The final version of the questionnaire (in English) consists of 18 items arranged in 9 pairs as in the original study [11] and was discussed with experienced psychiatrists to improve the validity. The questionnaire has been designed in such a manner that the answer of each odd-numbered item is inevitably the opposite of the following even-num- bered item, e.g. the preferable answer for item number 1 is ‘true’, while for item 2 it is ‘false’, and so on. Any combination of answers other than as above is therefore considered to include contradictory re- sponses. The study was approved by the Institutional Review Board of the CIP, Ranchi, India. The final questionnaire was adminis- tered to all psychiatry trainees (junior res- idents), pursuing a postgraduate (DPM/ MD) course in psychiatry at the CIP and they were invited to participate in the study. After informed consent, the train- ees were requested to mark 1 response (ei- ther ‘true’ or ‘false’ or ‘not sure’) for each item. The completed questionnaire was The assessment of mood and affect is a vital part in the Mental Status Examina- tion, which is a cornerstone of psychiatric assessment [1] and also helpful in the man- agement of different psychiatric disorders. Karl Jaspers describes affect as a momen- tary emotional perturbation and mood as a more prolonged emotional state that in- fluences all aspects of the mental state [2]. The German original of Jasper’s concepts [3] has retained some of its genuine flavor after translation and the subsequent litera- tures have added subtle complexities to these concepts. With the globalization of medicine, psychiatrists trained in various countries (India and other Asian regions where Eng- lish is often not their first language) may provide care in other areas like the USA, Canada and Australia. Hence, it is worth- while to compare the conceptualization of different terms of the Mental Status Exam- ination by the trainees of different coun- tries . Currently the conceptualization of the terms ‘mood’ and ‘affect’ is somewhat con- tradictory between textbooks. Some au- thors refer to mood as an internal, subjec- tive and sustained emotional state usually reported by patients and affect as an exter- nal, objective, visible, moment-to-moment emotional state which should be observed by an examiner [4, 5]. In other words, mood is a self-reported symptom, whereas affect is a physical sign noted by some au- thors [6, 7]. However, some authors refer to mood has both a subjective and an objec- tive component [8–10]. Received: September 6, 2007 Accepted after revision: January 15, 2008 Published online: July 19, 2008 Narayana Manjunatha Central Institute of Psychiatry Kanke Ranchi 834006 (India) Tel. +91 651 245 1142, Fax +91 651 223 3668, E-Mail nm.nimhans@gmail.com © 2008 S. Karger AG, Basel 0254–4962/08/0415–0336$24.50/0 Accessible online at: www.karger.com/psp collected back on the spot after sufficient time. Overall, 41 out of 43 psychiatry trainees gave informed consent and par- ticipated in the study. The mean ( 8 SD) age of the samples was 29.09 ( 8 3.10) years and their mean ( 8 SD) duration of train- ing in psychiatry was 25.80 ( 8 21.46) months at the time of this study. Almost 93% of the trainees in our study defined mood as pervasive and sustained, whereas 12.2% considered it as a moment- to-moment emotional tone, in contrast to the figures of the New York trainees of 60.6 and 50.5% respectively. A small portion of the CIP trainees (4.9%) conceptualized af- fect as pervasive, while it was considered momentary by 85.4% of them, as com- pared to 26.3 and 66.3% respectively by the New York trainees [11]. The CIP trainees gave fewer contradictory answers com- pared to the ones from New York in the sustained/momentary dimension and fo- cused more on the temporal aspect of the emotional tone. On the other hand, the CIP trainees gave significantly more contradictory an- swers compared to the New York ones [11] in the subjective/objective dichotomy and internal/external dimension, i.e. 22.0 ver- sus 1.0% for subjectivity, 17.1 versus 2.1% for objectivity and 24.4 versus 1.0% for the internal and 19.5 versus 1.0% for the exter- nal dimension, respectively. These contra- dictory responses by the CIP trainees may be due to their habit of reading both trans- atlantic (American and European) as well as Asian, mainly Indian, authors, where descriptions can differ. This discrepancy Downloaded by: George Washington Univ. Med.Ct 198.143.37.97 - 1/27/2016 12:40:19 PM