The Mental Status Exam
Behaviour
Facial expression, posture, gait, eye contact, ease of rapport
Level of Arousal
Psychomotor agitation / retardation, stupor
Movements
Tremor, repeated movements, echophenomena
Tremor
Resting / postural / intention / psychogenic
Rhythmic involuntary vibration of 1+ body parts
Repeated Movements
Mannerisms, stereotypes, compulsions
Goal-directed or purposeless
Echophenomena
Echolalia, echopraxia
Automatic repetition of words or movements
Attitude
Cooperative / hostile / secretive / suspicious / distracted
Affect & Mood
Cognition
Consciousness & Orientation
GCS, Richmond sedation scale
Level of Consciousness
Alert, drowsy, asleep, obtunded, fluctuant
Level of Sedation
Aggressive, alert, drowsy, sedated, unrousable
Orientation
To time / place / person
Attention & Concentration
Distractability, digit span
Distractability
Serial 7s, WORLD backward, months backward
Digit Span
Repeat 3 numbers, 4 numbers, 5 numbers etc.
Language
Speech, reading and writing
Speech
Expressive / receptive / articulation
Comprehension, repetition, naming
Language - Reading
Reading words or sentences out loud
Language - Writing
Write a sentence containing a subject and verb
Memory
Episodic (retro/anterograde), semantic
Retrograde Memory
Ability to recall recent and remote memories
Name, breakfast, medications, wedding day
Anterograde Memory
Ability to form new memories
Repeat back colour, animal, object 5 min later
Motor Ability (Praxis)
Copy an action with their hands; fist-palm-edge
Visuospatial Processing
Temporal / parietal lobes
Constructional Ability
Copy overlapping pentagons, wire cube, clock face
Visual Neglect
Inattention to one side, incomplete clock face
Executive Function
Frontal Lobe
Conceptualisation
Ability to distill general ideas from information
The similarity between bananas & oranges
Category Fluency
Words beginning with A, animals
Inhibitory Control
Tap when I tap once, do not tap when I tap twice
Thought
Content
Delusions, obsessions, overvalued ideas, depressive / anxious / psychotic content
Delusions
Rigidly held beliefs not consistent with background
Obsessions
Intrusive, repetitive thoughts
Overvalued Ideas
A large amount of time spent on unreasonable beliefs
Psychotic Content
Thought insertion / withdrawal / broadcasting, auditory hallucinations
Anxious Thought Content
Obsessions, generalised anxiety, phobias
Depressive Thought Content
Preoccupations, ruminations
Form
Relevance, changes of topic, vagueness, nonsense