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Mental Status Exam

Level of Arousal

November 7th, 2019


The patient's level of arousal is an assessment of how awake and active they are. Patients may be hyperactive or display psychomotor agitation, or conversely show evidence of psychomotor retardation or even stupor.


Hyperactivity refers to an increase in purposeful, goal-oriented activity. Examples might include excessive cleaning or excessive talking.
  • Significance

  • May be related to anxiety or mania.

Psychomotor Agitation

Pshcomotor agitation refers to purposeless, goal-less activity that the patient may be displaying; these 
  • Look For

  • Fidgeting
  • Wringing hands
  • Shifting position
  • Inability to remain seated
  • Pacing
  • Causes of Psychomotor Agitation

  • Anxiety disorders
  • Mood disorders - depression, bipolar affective disorder
  • Schizophrenia
  • Drug intoxication / withdrawal
  • Delirium
  • Dementia

Psychomotor Retardation

  • Look For

  • Reduced movement, speech and thinking.
  • Causes of Psychomotor Retardation

  • Depression
  • Frontal lobe pathology
  • Dementias
  • Hypothyroidism


A stupor is a state that lies somewhere between full awareness and coma.
  • Signs of Stupor

  • Mutism
  • Immobility
  • Unresponsiveness to stimuli
  • Disturbances in eating, drinking, defaecating and passing urine
  • Catalepsy: maintenance of an awkward posture or position
  • Causes of Stupor

  • Catatonia - depression, schizophrenia, stroke
  • Depressive stupor
  • Organic pathology - cerebral or brainstem lesions
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