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(Components of a Mental Status Examination 7/23/20, VII. Mood (Inquired):…
Components of a Mental Status Examination 7/23/20
II.Behavior (Observed)
:
psychomotor activity
gestures
Mannerisms
eye contact, ability to follow commands/requests,compulsions.
IV. Level of Consciousness (Observed)
stuporous, asleep, comatose,
confused, fluctuating.
Vigilant, alert, drowsy, lethargic,
III. Attitude (Observed)
Cooperative, hostile,
open, secretive, evasive, suspicious apathetic,
easily distracted, focused, defensive.
V. Orientation (Inquired)
“What is the full date today (date, month, year, day of the week, and season of the year)?”
“How would you describe the situation we are in?”
“What is your full name?”
• “Where are we at (floor, building, city, county, and state)?”
X. Thought Content (Inquired/Observed)
“Are there thoughts or images that you have a really difficult time getting out of your head?”
• “Are you worried/scared/frightened about something or other?”
• “Do you have personal beliefs that are not shared by others?” (Delusions are fixed, false, unshared beliefs.)
• “Do you ever feel detached/removed/changed/different from others around you?”
“What do you think about when you are sad/angry?”
• “What’s been on your mind lately?”
• “Do you find yourself ruminating about things?”
I. Appearance (Observed)
clothes, grooming.
Gait, posture,
VI. Speech and Language (Observed)
C. Volume (Tone) - Possible descriptors:
• Loud, soft, monotone, weak, strong.
D. Fluency and Rhythm - Possible descriptors:
• Slurred, clear, with appropriately placed inflections, hesitant, with good articulation, aphasic.
• Fast, slow, normal, pressured.
B. Rate - Possible descriptors:
• Talkative, spontaneous, expansive, paucity, poverty.
A. Quantity - Possible descriptors:
VIII. Affect (Observed): An observed expression of inner feeling
Range: Broad, restricted.
• Intensity: Blunted, flat, normal intensity.
Quality: Sad, angry, hostile, indifferent, euthymic, dysphoric
Appropriateness to situation, consistency with mood, congruency with thought content.
Fluctuations: Labile, even.
detached, elated, euphoric, anxious, animated,
irritable.
IX. Thought Processes or Thought Form (Inquired/Observed):
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 during the interview
VII. Mood (Inquired): A sustained state of inner feeling
• “How are your spirits?”
• “How are you feeling?”
• “Have you been discouraged/
“Have you been energized/elated/high/out of control lately?”
“Have you been angry/irritable/edgy lately?”
XI. Suicidality and Homicidality
Suicidality
• “What would happen after you were dead?”
“Have you ever thought of doing away with yourself? If so, how?”
“Do you ever feel that life isn’t worth living? Or that you would just as soon be dead?”
Homicidality
“Do you think about hurting others or getting even with people who have wronged you?”
• “Do you think about hurting others or getting even with people who have wronged you?”
• “Have you had desires to hurt others? If so, how?”
. Recent Memory
Memory (Inquired)
:
• “What is my name?”
• “What medications did you take today?”
Immediate Memory
Intellectual (Inquired/Observed) Information and Vocabulary -
Abstraction
Calculations - Suggested patient instructions:
• (Serial 7’s) “Starting with 100, subtract 7 from 100, and then keep subtracting 7 from that number as
far as you can go.”
• (Serial 3’s) “Starting with 20, subtract 3 from 20, and then keep subtracting 3 from that number as far
as you can
XII. Insight and Judgment (Inquired/Observed)
• “What brings you here today?”
• “What seems to be the problem?”
• “What do you think is causing your problems?”
• “How do you understand your problems?”
XIII. Attention (Inquired/Observed
A. Digit Span (forward and reverse) - 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.” [Begin with 3 numbers – not consecutive numbers, and advance to 7-8
numbered sequence.]
B. Spelling Backwards - Suggested patient instructions:
• “Spell the word ‘world.’ Now spell the word ‘world’ backwards.”