Psychiatry Mental Status Exam (MSE)
Practice Questions 2026-2027 | 115 DSM-5-
TR Board-Style Questions with Detailed
Explanations for USMLE, PRITE &
Psychiatry Board Review
Description:
Master the Psychiatric Mental Status Examination with 115 high-yield board-style
questions covering mood disorders, psychosis, thought processes, and clinical vignettes.
Updated for 2026-2027 DSM-5-TR criteria. Includes detailed answer explanations,
SIGECAPS & DIGFAST mnemonics, and AIMS monitoring. Perfect for USMLE Step
2/3, Psychiatry PRITE, and ABPN Board preparation.
Download now and ace your psychiatry exams!
, Psychiatry MSE QBank 2026-2027 | 115 Board-Style Questions
SECTION 1: PSYCHIATRIC REVIEW OF SYSTEMS
A. Mood Disorders
Question 1
A 34-year-old patient presents with depressed mood. Which of the following mnemonics is
most appropriate for systematically assessing the cardinal symptoms of major depressive
disorder?
A) SIGECAPS
B) DIGFAST
C) SIGNS
D) CAPS
Answer: A) SIGECAPS
Explanation: SIGECAPS is the standard mnemonic for assessing major depressive disorder
symptoms: Sleep, Interest (anhedonia), Guilt, Energy, Concentration, Appetite, Psychomotor
changes (agitation or retardation), and Suicidality. DIGFAST is used for mania assessment.
The other options are not standard psychiatric mnemonics.
Question 2
Which of the following symptom clusters is most characteristic of a manic episode?
A) Decreased sleep, increased appetite, psychomotor retardation, and guilt
B) Grandiosity, decreased need for sleep, pressured speech, and excessive involvement in
pleasurable activities with high potential for painful consequences
C) Insomnia, weight loss, agitation, and anhedonia
D) Hypersomnia, hyperphagia, and leaden paralysis
Answer: B) Grandiosity, decreased need for sleep, pressured speech, and excessive
involvement in pleasurable activities with high potential for painful consequences
Explanation: The manic symptom cluster includes grandiosity, decreased need for sleep (not
just insomnia), pressured speech, racing thoughts, distractibility, increased goal-directed
,activity, and excessive involvement in high-risk activities. Option C describes depressive
symptoms. Option D describes atypical depression features.
Question 3
A patient reports persistent irritability and mood lability. These symptoms are best classified
under which category of mood disturbance?
A) Major depressive episode
B) Mixed mood state
C) Manic episode
D) Dysthymic disorder
Answer: B) Mixed mood state
Explanation: Mixed mood states feature simultaneous presence of depressive and manic
symptoms, commonly presenting with irritability, mood lability, and affective instability.
Irritability alone can occur in multiple conditions but when accompanied by lability, it
suggests a mixed or dysregulated mood state.
B. Anxiety Disorders
Question 4
In evaluating a patient for generalized anxiety disorder, which of the following assessment
parameters is most essential?
A) Presence of obsessive thoughts
B) Duration of symptoms (≥6 months) and the "3 Ws" (Where, When, Who)
C) History of panic attacks
D) Presence of specific phobias
Answer: B) Duration of symptoms (≥6 months) and the "3 Ws" (Where, When, Who)
Explanation: The evaluation of GAD requires excessive anxiety and worry occurring more
days than not for at least 6 months. The "3 Ws"—Where (situational triggers), When (time
course), and Who (social context)—help characterize the worry pattern. Panic attacks,
obsessions, and phobias are assessed separately under their respective disorders.
, Question 5
Which of the following characteristics distinguishes panic disorder from other anxiety
disorders?
A) Fear of specific objects or situations
B) Recurrent unexpected panic attacks followed by at least one month of persistent concern
about additional attacks or significant maladaptive behavioral changes
C) Excessive worry about multiple life circumstances
D) Avoidance of social situations due to fear of negative evaluation
Answer: B) Recurrent unexpected panic attacks followed by at least one month of persistent
concern about additional attacks or significant maladaptive behavioral changes
Explanation: The diagnostic criteria for panic disorder include recurrent unexpected panic
attacks and at least one month of persistent concern about additional attacks, worry about
consequences, or significant maladaptive change in behavior related to the attacks. Somatic
symptoms include palpitations, sweating, shortness of breath, and fear of dying.
Question 6
A patient describes recurrent, intrusive thoughts about contamination and engages in
excessive hand-washing rituals. These symptoms are most consistent with:
A) Generalized anxiety disorder
B) Obsessive-compulsive disorder
C) Panic disorder
D) Illness anxiety disorder
Answer: B) Obsessive-compulsive disorder
Explanation: OCD is characterized by obsessions (recurrent, persistent thoughts, urges, or
images that are intrusive and unwanted) and compulsions (repetitive behaviors or mental acts
the individual feels driven to perform). Common themes include contamination, checking,
symmetry, and aggressive/sexual obsessions. The patient's description of contamination fears
and excessive hand-washing directly aligns with OCD presentation.
Practice Questions 2026-2027 | 115 DSM-5-
TR Board-Style Questions with Detailed
Explanations for USMLE, PRITE &
Psychiatry Board Review
Description:
Master the Psychiatric Mental Status Examination with 115 high-yield board-style
questions covering mood disorders, psychosis, thought processes, and clinical vignettes.
Updated for 2026-2027 DSM-5-TR criteria. Includes detailed answer explanations,
SIGECAPS & DIGFAST mnemonics, and AIMS monitoring. Perfect for USMLE Step
2/3, Psychiatry PRITE, and ABPN Board preparation.
Download now and ace your psychiatry exams!
, Psychiatry MSE QBank 2026-2027 | 115 Board-Style Questions
SECTION 1: PSYCHIATRIC REVIEW OF SYSTEMS
A. Mood Disorders
Question 1
A 34-year-old patient presents with depressed mood. Which of the following mnemonics is
most appropriate for systematically assessing the cardinal symptoms of major depressive
disorder?
A) SIGECAPS
B) DIGFAST
C) SIGNS
D) CAPS
Answer: A) SIGECAPS
Explanation: SIGECAPS is the standard mnemonic for assessing major depressive disorder
symptoms: Sleep, Interest (anhedonia), Guilt, Energy, Concentration, Appetite, Psychomotor
changes (agitation or retardation), and Suicidality. DIGFAST is used for mania assessment.
The other options are not standard psychiatric mnemonics.
Question 2
Which of the following symptom clusters is most characteristic of a manic episode?
A) Decreased sleep, increased appetite, psychomotor retardation, and guilt
B) Grandiosity, decreased need for sleep, pressured speech, and excessive involvement in
pleasurable activities with high potential for painful consequences
C) Insomnia, weight loss, agitation, and anhedonia
D) Hypersomnia, hyperphagia, and leaden paralysis
Answer: B) Grandiosity, decreased need for sleep, pressured speech, and excessive
involvement in pleasurable activities with high potential for painful consequences
Explanation: The manic symptom cluster includes grandiosity, decreased need for sleep (not
just insomnia), pressured speech, racing thoughts, distractibility, increased goal-directed
,activity, and excessive involvement in high-risk activities. Option C describes depressive
symptoms. Option D describes atypical depression features.
Question 3
A patient reports persistent irritability and mood lability. These symptoms are best classified
under which category of mood disturbance?
A) Major depressive episode
B) Mixed mood state
C) Manic episode
D) Dysthymic disorder
Answer: B) Mixed mood state
Explanation: Mixed mood states feature simultaneous presence of depressive and manic
symptoms, commonly presenting with irritability, mood lability, and affective instability.
Irritability alone can occur in multiple conditions but when accompanied by lability, it
suggests a mixed or dysregulated mood state.
B. Anxiety Disorders
Question 4
In evaluating a patient for generalized anxiety disorder, which of the following assessment
parameters is most essential?
A) Presence of obsessive thoughts
B) Duration of symptoms (≥6 months) and the "3 Ws" (Where, When, Who)
C) History of panic attacks
D) Presence of specific phobias
Answer: B) Duration of symptoms (≥6 months) and the "3 Ws" (Where, When, Who)
Explanation: The evaluation of GAD requires excessive anxiety and worry occurring more
days than not for at least 6 months. The "3 Ws"—Where (situational triggers), When (time
course), and Who (social context)—help characterize the worry pattern. Panic attacks,
obsessions, and phobias are assessed separately under their respective disorders.
, Question 5
Which of the following characteristics distinguishes panic disorder from other anxiety
disorders?
A) Fear of specific objects or situations
B) Recurrent unexpected panic attacks followed by at least one month of persistent concern
about additional attacks or significant maladaptive behavioral changes
C) Excessive worry about multiple life circumstances
D) Avoidance of social situations due to fear of negative evaluation
Answer: B) Recurrent unexpected panic attacks followed by at least one month of persistent
concern about additional attacks or significant maladaptive behavioral changes
Explanation: The diagnostic criteria for panic disorder include recurrent unexpected panic
attacks and at least one month of persistent concern about additional attacks, worry about
consequences, or significant maladaptive change in behavior related to the attacks. Somatic
symptoms include palpitations, sweating, shortness of breath, and fear of dying.
Question 6
A patient describes recurrent, intrusive thoughts about contamination and engages in
excessive hand-washing rituals. These symptoms are most consistent with:
A) Generalized anxiety disorder
B) Obsessive-compulsive disorder
C) Panic disorder
D) Illness anxiety disorder
Answer: B) Obsessive-compulsive disorder
Explanation: OCD is characterized by obsessions (recurrent, persistent thoughts, urges, or
images that are intrusive and unwanted) and compulsions (repetitive behaviors or mental acts
the individual feels driven to perform). Common themes include contamination, checking,
symmetry, and aggressive/sexual obsessions. The patient's description of contamination fears
and excessive hand-washing directly aligns with OCD presentation.
