NCM 101

ASSESSMENT OF MENTAL STATUS

March 24, 2022

Mental Status - a person’s emotional (feeling) and cognitive (knowing) function

The patient's attention span is assessed first; an inattentive patient cannot cooperate fully and
hinders testing. Any hint of cognitive function such as the following:

★ Orientation to time, place, person

★ Attention and concentration
★ Memory
★ Verbal and mathematical abilities
★ Judgment
★ Reasoning

Components of Mental State Assessment

1. Appearance
● Age (chronological age and whether person looks their age)
● Sex
● Race
● Body Build (Thin, obese, athletic)
● Position (lying, sitting, standing, kneeling)
● Posture (rigid, slumped, slouched, comfortable, threatening)
● Eye contact (eyes closed, good contact, avoid contact, snares)
● Dress (what the individual is wearing, cleanliness, condition of clothes, neatness,
appropriate of garments )
● Grooming (malodorous, intempt, dirty, unshaven overly meticulous, hairstyle,
disheveled, make-up)
● Manner (cooperative, guarded, pleasant, suspicious, glb, angry, seductive,
ingratiating, evasive, friendly, hostile)
● Attentiveness to examiner (disinterested, bored, internally preoccupied,
distractible, attentive)
● Distinguishing features (scars, tattoos, bandage, blood stain, missing teeth,
tobacco stained fingers)
● Prominent physical irregularity (missing limb, jaundice, profuse sweating, goiter,
wheezing, coughing)
● Emotional facial expression (crying, calm, perplexed, stressed, tense, screaming,
tremulous, furrowed brow)
● Alertness (alert, drowsy, stupor, confused)
2. Motor /Behavior
● Retardation (slowed movement)
● Agitation (unable to sit still, wringing hands, rocking, picking of skin or clothing,
pacing, excessive movement, compulsive)
● Unusual movements (tremor, lip smacking, tongue thrust, mannerisms, grimace,
tics)
● Gait (shuffling, limping, hesitation)
● Catatonia (stupor, excitement)

3. Speech
● Rate (slowed, long pauses before answering questions, rapid, hesitant,
pressured)
● Rhythm (monotonous, shuttering)
● Volume (loud, soft, whispered)
● Amount (monosyllabic, hypertalkative, mute)
● Articulation (clear, mumbled, slurred)
● Spontaneity

4. Mood/Affect
● Stability (stable, fixed, labile)
● Range (constricted, full)
● Appropriateness (to content of speech and circumstance)
● Intensity (flat, blunted, exaggerated)
● Affect ( depressed, sad, happy, euphoric, irritable, anxious, neutral, tearful,
angry, pleasant)
● Mood (reported by patient/client)

5. Thought Content
● Suicidal, or homicidal ideations (intent, plan, access to means)
● Demssive cognition (guilt, worthlessness, hopelessness )
● Obsessions (persistent, unwanted, recurring thought)
● Phobias (persistent, strong, fear of object or situation)
● Ideas of reference
● Paranoid ideation
● Magical ideation
● Delusion (false belief kept despite no supportive evidence
● Over valued ideas
● Thought broadcasting, insertion or withdrawal
● Other major themes discussed by patient

6. Thought Process
● Coherence
● Logic (logical, illogical)
 ● Steam (goal directed, circumstantial, looseness of association, flight of ideas,
rambling, word salad)
● Perseveration (pathological repetition of a sentence or word )
● Neologism (use of new expression, phrases, words)
● Attention (distractibility, concentration)
● Blocking (sudden cessation of flow of thinking and speech related to strong
emotion)

7. Perception
● Hallucination (auditory, visual, olfactory, glutatory, tactile)
● Illusions (misinterpretation of actual external stimuli )
● Depersonalization

8. Cognition
● Orientation (time, person, place)
● Memory (short term, long term)
● Intellect
● Abstract thought
● Capacity to read and write
● Level of consciousness

9. Insight/ Judgment
● Awareness of illness (insight)
● Ability to make decisions wisely considering pros and cons for the course of
action.