The mental status examination is a structured assessment of the patient's behavioral and cognitive functioning. It includes descriptions of the patient's appearance and general behavior, level of consciousness and attentiveness, motor and speech activity, mood and affect, thought and perception, attitude and insight, the reaction evoked in the examiner, and, finally, higher cognitive abilities. The specific cognitive functions of alertness, language, memory, constructional ability, and abstract reasoning are the most clinically relevant.
ASPECTS OF MENTAL STATUS EXAM :-
A synopsis of the four MSE sections is presented below. In following pages, there are elaborations of each section, with sample descriptors.
1.General Observations
Appearance
Speech
Behavior
Cooperativeness
2.Thinking
Thought Process
Thought Content
Perceptions
3.Emotion
Mood
Affect
4.Cognition
Orientation/Attention
Memory
Insight
Judgment
GENERAL OBSERVATIONS :-
Appearance
1.Hygiene: clean, body odor, shaven, grooming 2.Dress: clean, dirty, neat, ragged, climate appropriate — anything unusual?
3.Jewelry: rings, earrings — anything unusual? 4.Makeup: lipstick, nail polish, eye makeup — anything unusual?
5.Other: prominent scars, tattoos
Speech
1.General: accent, clarity, stuttering, lisp
2.Rate: fast (push of speech) or slow
3.Latency (pauses between questions and answers): increased or decreased
4.Volume: whispered, soft, normal, loud 5.Intonations: decreased (monotone), normal
Behavior
1.General: increased activity (restlessness, agitation), decreased activity
2.Eye Contact: decreased, normal, excessive, intrusive
3.Mannerisms, stereotypies, posturing
Cooperativeness
1.Cooperative, friendly, reluctant, hostile
THINKING:-
Thought Processes :- Observation of the client attitude towards various people and things in the environment in the forms of ideas.
.Tight, logical, goal directed, loosened, circumstantial, tangential, flight of ideas, word salad
Thought Content
Future oriented, suicidal ideation, homicidal ideation, fears, ruminative ideas
Perceptions
1.Hallucinations (auditory, visual, olfactory) 2.Delusions (paranoid, grandiose, bizarre) 3.Illusion
4.Dejavu
5.Abnormal vestibular sensations 6.Depersonalization
EMOTIONS :-
Mood and affect :- It is a pervasive feeling tone which sustained. Affect is tha subjective and immediate experience of emotions.
Appearance is the index the mind Intensity of
1.happiness
2.Sadness
3.Irritability
4.Anger
5.Suspiciousness
6.Blurred
consistency of mood and related to the topic :
Shallowness /superficiality /absense of mood/euphoria
1.Reactivity
2.Diurnal variation
3.Congruity
4.Liability
COGNITION :-
Level of conciousness :- conscious or alert /confusion /clouding/delirium/stupour
Intelligence :- It is the ability to think logically act rationally and deal effectively with the environment.
Orientation/Attention
Day, date, month, year, place, president; Serial 7's (or 3's), WORLD — DLROW, digit span
Memory
1.Immediate memory :- Telling and ask the client to grasp and repeat immediately
2.Recent memory :- Ask the client who brought him to hospital, when he came, give an address to memorize and ask to recall 15 minutes later
3.Remote memory :- Personal events like marriage date, situations during marriage or the job, impersonal events - situation related to environment
4.Events related to illness :- with what complaints the illness started, where he has taken treatment.
Insight/Judgment
Good, limited or poor (based on actions, awareness of illness, plans for the future)
0 Comments