Mental Status Examination

I. General Appearance: Describe also manner of clothing (if appropriate to the occasion or not),
if subject looks appropriate to chronologic age

II. Behavior: tics/ mannerisms, eye contact

III. Attitude towards Examiner: Cooperative, guarded, uncooperative

IV. Mood: ASK: How do you feel? What is your mood today?

V. Affect: OBSERVE.
Range of affect: broad-ranged, constricted, blunted, flat
Appropriateness

VI. Speech: OBSERVE.

Spontaneous or not
Volume
Hypo-, normo-, hyperproductive
Pressured or not

VII. Perceptual disturbances: ASK

illusions
Hallucinations: visual, auditory, tactile, olfactory

VIII. Thought process: OBSERVE

Goal-oriented
Flight of ideas/ Looseness of associations
Circumstantiality/ tangentiality

IX. Thought content: ASK

Preoccupations
Ideations/ delusions
Suicidal/ homicidal ideations

X. Orientation
Time, place and person

XI. Memory
Immediate recall
Recent
Recent past
Remote

XII. Fund of knowledge

XIII. Attention/ Concentration
Serial 7s

XIV. Reading/ Writing

Write a sentence/ their name
Read a sentence

XV. Visuospatial ability

Interlocking pentagons or draw a clock

XVI. Ability to follow a three-step command

XVII. Abstract reasoning

Interpret proverbs

XVIII. Judgment
Ability to predict consequences of an action
Test judgment/ social judgment

XIX. Impulse control: OBSERVE

XX. Insight: ASK. What do you understand of your condition?

6 levels of insight
Levels of Insight
Level 1: Complete denial of illness
Level 2: Awareness of being ill, but denying it at the same time
Level 3: Awareness of being ill but blames illness on external factors
Level 4: Awareness of being ill but not knowing the cause
Level 5: Intellectual Insight
Level 6: True Emotional Insight