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Mental Status - Coggle Diagram
Mental Status
Intellectual
Intellectual (Inquired/Observed)
Information and Vocabulary - Suggested patient instructions:
“Name the last 5 presidents.” (Clinton, Bush, Reagan, Carter, Ford, Nixon, …)
“Name 5 of the largest cities in the country.” (New York City, Los Angeles, Chicago, Houston,
Philadelphia)
“Name the current president, vice president, governor, and mayor.” (Bill Clinton, Al Gore, George
Ryan, Richard M. Daley)
Vocabulary - Possible descriptors:
Grade school level, high school level, fluent, consistent with education.
Abstraction - Possible questions for patient:
Similarities – “How are the following items similar?”
“an apple and an orange” (round ~concrete, fruit ~abstract)
“a chair and a table” (made of wood ~concrete, furniture ~abstract)
“a watch and a ruler” (measurement instruments ~abstract)
Proverbs – “How would you describe the meaning of the following sayings?”
“People living in glass houses should not throw stones.”
“You shouldn’t cry over spilt milk.”
“Two heads are better than one.”
Memory
Memory (Inquired)
Recent Memory – Possible questions for patient:
“What is my name?”
“What medications did you take today?”
“What time was your appointment with me for today?”
Remote Memory – Possible questions for patient:
“Where were you when President Kennedy was shot?” (For patients over 40)
“What is your Social Security number?”
“What were the dates of your graduation from high school, college, graduate school?”
“When and where did you get married?”
Immediate Memory (also see XIII.-A. above) and New Learning - Suggested patient instructions:
“I am going to ask you to remember three words (color, object, animal – e.g., blue, table, and horse)
and I will ask you to repeat them to me in 5 minutes. Please repeat them now after me: blue, table,
and horse.” – 5 minutes elapse – “What were those three words I asked you to remember?” [Monitor
accuracy of response, awareness of whether responses are correct, tendency to confabulate or
substitute other words, ability to correct themselves with category clue and multiple choice].
Insight and Judgment (Inquired/Observed) – Possible questions for patient:
“What brings you here today?”
“What seems to be the problem?”
“What do you think is causing your problems?”
Insight /Judgment
“How do you understand your problems?”
“How would you describe your role in this situation?”
“Do you think that these thoughts, moods, perceptions, are abnormal?”
“How do you plan to get help for this problem?”
“What will you do when __ occurs?”
“How will you manage if _ happens?”
“If you found a stamped, addressed envelope on the street, what would you do with it?”
“If you were in a movie theater and smelled smoke, what would you do?”
Level of Consciousness
Alert
Fluctuating
Drowsy
Confused
Vigilant
Lethargic
Stuporous
Sleep
Behavior Observed
Grooming
Gestures
Mannerisms
Psychomotor Activity
Expression
Eye Contact
Ability To Follow Comands
Compulsions
Appearance Observed
Gait
Grooming
Clothing
Posture
Orientation Inquired
"Where are we at (floor, building,city, county, and state)?"
"What is the full date today (date, month,year,day of week, and season of year."
"What is your full name?"
"ow would you describe the situation we are in?"
Mood Inquired:
"How are your spirits?"
"How are you feeling?"
Have you been discouraged/depressed/low/blue lately?"
"Have you been energized /elated/high/out of control lately?"
"Have you been angry/irritable/edgy lately?"
Speech & Language
Volume (Tone)- Possible descriptor:Loud, soft,monotone, weal,strong
Fluency and Rhythm- Possible descriptors: Slurred, clear, with appropriately placed inflections, hesitant, good articulation, aphasic
Rate - Possible descriptors: Fast, slow, normal,pressured
Quantity- Possible descriptors: talkative,spontaneous,expansive,paucity, poverty.
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“Multiply these numbers: (25 x 6)”
“Add these numbers: (15 + 12 + 7)”
[Monitor for speed, accuracy, effort required, and monitor patient reactions to the
request]
(Serial 3’s) “Starting with 20, subtract 3 from 20, and then keep subtracting 3 from that number as far
as you can go.”
(Serial 7’s) “Starting with 100, subtract 7 from 100, and then keep subtracting 7 from that number as
far as you can go.”
Calculations - Suggested patient instructions:
“Spell the word ‘world.’ Now spell the word ‘world’ backwards.”
Spelling Backwards - Suggested patient instructions:
“I will recite a series of numbers to you, and then I will ask you to repeat them to me, first forwards
and then backwards.”
Digit Span (forward and reverse) - Suggested patient instructions:
Attend, concentration, distractibility.
Attention (Inquired/Observed) - Possible descriptors:
Affect
Fluctuations: Labile, even.
Range: Broad, restricted.
Intensity: Blunted, flat, normal intensity.
Appropriateness to situation, consistency with mood, congruency with thought content.
Quality: Sad, angry, hostile, indifferent, euthymic, dysphoric, detached, elated, euphoric, anxious, animated,
irritable.
Linear, goal-directed, circumstantial, tangential, loose associations, incoherent, evasive, racing, blocking,
perseveration, neologisms.
logic, relevance, organization, flow and coherence of
thought in response to general questioning
Thought Processes or Thought Form (Inquired/Observed):
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Attitude Observed
Drowsy
Lethargic
Alert
Stuporous
Cooperative
Asleep
Comatose
Apathetic
Easily Distracted
Defensive