Mental Status Examination and Related Definitions
| Category | Description | Related Definitions |
|---|---|---|
| Appearance | Describe what patient looks like including dress, posture, grooming. | |
| Behavior | Describe behavior, motor activity, mannerisms. | Catatonic: Remaining totally immobile Posturing: Assuming inappropriate or bizarre positions Compulsions: Insistent, repetitive unwanted actions |
| Speech | Describe how patient speaks; list barriers to communication. | Perseveration: Mechanical repetition or words, thoughts Pressured: Highly accelerated rapid speech Loose associations: Absence of logical connections between thoughts Flight of ideas: Rapidly jumping from one thought to another with minimal links Tangential: Talking around main point Word salad: Unconnected words and phrases without meaning or logic Thought blocking: Stopping suddenly in the middle of verbalizing a thought and staring into space Neologism: Making up new words only speaker understands |
| Mood/affect | Describe the emotions that are apparent from facial expressions, motor behavior, words used. | Labile: Emotions that change quickly and unpredictably Flat affect: No demonstration of any feeling Blunted affect: Constricted display of emotions Anhedonia: Absence of any pleasure Inappropriate affect: Emotions displayed not fitting with topic discussed Ambivalence: Contradictory feelings experienced simultaneously |
| Thoughts | What are themes in conversation? Does patient make sense? Is patient preoccupied with certain thoughts? | Hallucinations: Sensory perceptions (auditory, visual, gustatory, olfactory, tactile) without external stimuli, e.g., hearing nonexistent voices. Illusions: Misinterpretations of real external sensory stimuli, e.g., seeing a ghost in a shadow Delusions: False, fixed beliefs not alterable by logical explanations Obsessions: Unwanted, distressing recurring thoughts Phobia: Irrational fear of a specific situation, accompanied by avoidance of the phenomenon feared Depersonalization: Sense of not being real; sense of being detached from one’s body or self Magical thinking: Believing that thinking about something happening is the same as doing it Grandiosity: Exaggerated beliefs in own worth and/or abilities Paranoia: Unwarranted belief that others have harmful intentions to person |
| Ability to abstract | Describe the patient’s ability to define similarities between objects or explain a proverb. | Concrete description: See objects in very definite simple ways, e.g., sees an apple and an orange as “round” rather than the overall category “fruit” Abstract ability: Can generalize the meaning of a concept and find meaning in symbols, e.g., “still water runs deep” means that quiet people have depth rather than lakes are deep bodies of water |
| Memory | Describe patient’s ability to repeat the names of 3 objects immediately after being told and again in 5 minutes. | |
| Intelligence | Describe patient’s level of knowledge, language, understanding of instructions. | |
| Concentration | Describe patient’s ability to focus on a single thought without becoming distracted. | Serial 7s: Test to determine the patient’s ability to concentrate by having him or her continually subtract from 100 by 7 (93, 86, etc.) |
| Orientation | Describe patient’s awareness of person and surroundings. A person is fully oriented when he or she is aware of person, place, time and situation. | Orientation to person: Knows his or her name Orientation to place: Knows where he or she is (Ask for specific location.) Orientation to time: Knows the date, day of week, year; most serious impairment is if the patient cannot identify year Orientation to situation: Knows what is wrong with him or her, why he or she is receiving care, the circumstances of current situation |
| Judgment | Describe patient’s ability to use common sense to make reasonable decisions. | |
| Insight | Determine patient’s understanding of factors contributing to his or her condition. |