Mental Status Examination - 1

1
Mental Status Examination

• It is a structured way of observing and

describing a patient’s current state of
mind, under the domains of appearance,
attitude, behavior, mood and affect, speech,
thought process, thought content,
perception, cognition, insight and judgment.

2
Contd…

• Purpose: to obtain a comprehensive cross-

sectional description of the patient's
mental state, which, when combined with
the information of the history, allows the
clinician to make an accurate diagnosis and
formulation, which is required for coherent
treatment planning.

3
Contd…

• The data is collected through a combination

of direct and indirect means: unstructured
observation while obtaining the
biographical and social information,
focused questions about current
symptoms, and formalized psychological
tests

4
 Consciousness
• State of awareness of self and environment
• Intensity of stimulation needed to arouse the
patient and duration of time patient can
maintain attention
• 5 levels of consciousness on a continuum-
normal, drowsiness, stupor, coma
• Glasgow coma scale – eye opening, verbal and
motor response

5
Rapport
• Spontaneous feeling of harmonious
responsiveness that promotes development
of a constructive therapeutic alliance.

• Implies an understanding and trust between

the doctor and the patient

6
General appearance
• Appearance
• Appropriateness to situation
• Build, Prominent physical abnormalities
• Handedness
• Eye to eye contact
• Facial expression and posture
• Manner of relating
• Attitude towards examiner

7
Motor behavior
• Rate or speed
• Purposive and goal directedness
• Response to external stimuli
• Catatonic features
• Involuntary movements
• Abnormal movements

8
Attention
• Patients ability to attend to a specific
stimulus without being distracted by
internal or external stimuli
• Evaluation-
Digit span test- digit forward and
digit backward
5-7 digits is normal

9
Concentration

• Is the ability to maintain attention to a

specific stimulus over an extended period
• Evaluation-
Serial subtraction tests- 100-7, 40-3, 20-1
Month and days backwards
‘A’ test

10
Language functions
• Phonation
• Articulation
• Fluency- ability to produce spontaneous
speech
– animal naming test- 18-22/min
– FAS test(not including proper names)
• Comprehension- pointing commands and
yes or no questions

11
Contd…

• Repetition- sentences with 19 syllables

• Naming- body parts, objects, colors
• Reading- reading comprehension and
reading aloud; education
• Writing
• Prosody- tonal intonations

12
Orientation

• Time

• Place

• Person

• Sense of passage of time

13
Memory
• Complex set of processes where a person
registers, stores, and retrieves information
within different modalities and across
different time periods
• Immediate- Digit span test
• Recent- Address test
Object test
Recall of events
• Remote- personal and impersonal events
• Topographic memory
• Memory of skills 14
Abstract Ability
• Abstract thinking is the ability to grasp the
essentials of a whole, to break it into parts,
and to discern common properties
• Ability to deal with concepts
• Tests- Proverb interpretation
Test of similarity and dissimilarity
• Concrete, semi-abstract, abstract

15
Judgment
• Ability to assess situation correctly and
act appropriately with in that situation
• Test judgment- response in test
situation
• Social- history and observation
• Personal- about present and future

16
General information
• Based on educational, social background

Calculation
• Verbal and written- 1 or 2 step problem

Intelligence
• Capacity to solve problems, cope with new
situations, acquire skills through learning
and experiences, establish logical deductions,
and to form abstract concepts
17
• Thank You

18