Mental Status Examination

1. General Appearance
a. Weight – Normal/ Obese/ Over-Weight/ Under-Weight
b. Hair – Well-kempt/ Bizarre Style/ Unnatural Color/ Unkempt
c. Dress - Underdressed/ Overdressed/ Bizarre/ Normal Wear
d. Eye Contact - Present/ Partial/ Absent
e. Rapport - Easily Established/ Established with Difficulty
f. Touch with Surroundings - Present/ Partial/ Absent
g. Attitude towards examiner - Cooperative/ Defensive/
Guarded/Suspicious/Uncooperative/ Integrating/ Hostile/ Others

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2. Motor Behavior
Hyperactive/ Restless/ Awkward Gestures/ Self-Injurious/ Retarted/ Tics/
Mannerism/ Stereotypes/ Hallucinatory Behavior/ Touching Examiner/
Utilization Behavior/ Aggressive/ Preoccupied/ Silly/ Smiling/ Rigidity

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3. Mood/ Affect :
a. Subjective: Diurnal Variation:
Verbatim:
b. Objective: Anxious/ Panicky/ Fearful/ Depressed/ Weeping/ Irritable/
Cheerful/ Europhic/ Blunted/ Flat/ Others
c. Depth: Normal/ shallow
d. Range: Adequate/ Restricted
e. Stability: Stable/ Labile/Inconsistent
f. Congruence to Thought:
g. Appropriate to the Situation:
h. Communicability:
i. Reactivity to the Situation:
4. Speech
a. Intensity/ Tone: Soft/ Audible/ Loud/ Whispering
b. Reaction to Stimulus: Immediate/ Shortened/ Delayed/ Normal
c. Speed: Normal/ Very Slow/ Rapid/ Pressure of Speech
d. Prosody/ Tempo: Normal/ Fluctuation/ Monotonous
e. Ease of Speech: Spontaneous/ hesitant/ Mute/ Slurring/ Shattering/
Whispering / Muttering/ Speaks only when questioned
f. Productivity: Normal/ Over abundant/ Poverty of speech/ Poverty of Content
g. Relevant/ Irrelevant to the Context:
h. Coherent/ Incoherent:
i. Goal Direction : Goal directed/ Non- Goal directed/ Directed/ Circumstantial/
Tangential

5. Thought Content and Thought Process

a. Stream:
1. Normal :
2. Retarded:
3. Accelerated: Thought Blocking:
Circumstantiality:
Flight of Ideas:
Prolixity:
Pressure of Speech:

Form
ii. Normal/ derailment/ Loosing of Association/ Neologism/ Word Salad/
Incoherence/ Clang/ Illogicality/ Tangentiality/ Distractible/
Circumstantiality/ Loss of Goal/ Self Reference

b. Possession
i. Obsession/ Compulsion:
ii. Thought Alienation: Thought Insertion/ Thought Broadcasting/
Thought Withdrawn
c. Content:
i. Religious Preoccupation/ Philosophical Preoccupation/ sex
Preoccupation/ Somatic Preoccupation/ Preoccupation with
Precipitating Factors/ Excess Day Dreaming
ii. Phobia
iii. Ideas of Hopelessness/ Helplessness/ Worthlessness/ Ideas of Guilt/
 Death Wishes/ Suicidal Thoughts/ Homicidal Ideas/
Hypochondriacal Ideas iv. Ideas of Reference/
Persecution/ Grandiosity/ Infidelity
v. Delusion: Present/ Absent

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6. Perception
a. Illusion: Present/ Absent
b. Hallucination: Present/ Absent
c. Types of Hallucination: Auditory/ Visual/ Tactile/ olfactory

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Sample Talk-
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7. Cognition :
a. Orientation :
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Place

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Person

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 Time

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b. Attention and Concentration

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Comment-
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c. Memory
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i. Recent Memory
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Answer:
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Comment
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ii. Remote Memory

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iii. Immediate Memory

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d) Abstraction
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e) General Intelligence
i. Information
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ii. Calculation

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iii. Comprehension

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iv. Vocabulary

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f) Judgement:
a. Test: Poor/ Satisfactory/ Intact
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b. Personal - Poor/ Satisfactory/ Intact

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c. Social - Poor/ Satisfactory/ Intact

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Comment:
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8. Insight:
Grade 1: Complete Denial Of Illness
Grade 2: Slight awareness of being sick but denying at the same time
Grade 3: Awareness of being sick but blaming it on external factors
Grade 4: Awareness that illness is due to something unknown in the patient
Grade 5: Intellectual Insight
Grade 6 : Emotional Insight
FACTORS BIOLOGICAL PSYCHOLOGICAL SOCIAL

Predisposing

Precipitating

Perpetuating

9. Diagnostic Formulation:

10. Provisional Diagnosis:

 Points in favor Points against

11. Differential Diagnosis:

Points in favor Points against

12. Management Plan: