mental status examination mental status examination mental state examination abbreviated important clinical assessment process psychiatric practice structured way observing describing patient current state mind domains appearance attitude behavior mood affect speech thought process thought content perception insight judgment minor variations subdivision sequence names domains purpose obtain comprehensive cross description patient mental state combined biographical historical information psychiatric history allows accurate diagnosis required coherent treatment planning data collected combination direct indirect means observation obtaining biographical social information focused questions current symptoms psychological tests confused mini mental state examination brief psychological screening test theoretical foundations derives approach known descriptive descriptive developed work philosopher psychiatrist perspective assumed way patient experience description approach non theoretical distinct approach assumes analyst understand experiences processes patient unaware defense mechanisms unconscious drives practice blend descriptive clinical observation argued term corrupted clinical current usage set supposedly objective descriptions psychiatric patient synonym signs symptoms incompatible original meaning concerned patient experience application mental status examination core skill qualified mental health personnel key initial psychiatric assessment patient psychiatric hospital setting systematic collection data based observation patient behavior patient view interview purpose obtain evidence symptoms signs mental disorders including danger self present time interview information patient insight judgment capacity abstract reasoning inform decisions treatment strategy choice appropriate treatment setting carried manner informal combination open closed questions supplemented structured tests assess considered comprehensive physical examination performed physicians nurses performed abbreviated way non mental health settings information usually recorded free form text standard brief available use emergency situations example emergency department staff information obtained biographical social information psychiatric history generate diagnosis psychiatric treatment plan domains appearance assess physical aspects appearance patient including apparent age height weight manner dress colorful bizarre clothing suggest dirty clothes suggest depression patient appears older chronological age suggest chronic poor self care ill health clothing accessories particular body modifications clothing typical patient gender clues personality observations physical appearance include physical features alcoholism drug abuse signs dental erosion mouth abuse needle track marks drug abuse observations include odor suggest poor personal extreme self neglect alcohol weight loss disorder physical illness chronic anxiety attitude attitude known refers patient approach interview process quality information obtained assessment behavior behavior called activity include observations specific abnormal movements general observations patient level activity observations patient eye contact abnormal movements example movements indicate disorder indicate condition effects medication patient quasi movements syndrome range movement typical flexibility repetitive movements rocking head mannerisms repetitive quasi abnormal movements gesture abnormal feature chronic global noted increase movement described reflect inability sit represent effect medication similarly global decrease movement described indicate depression medical condition disease comment eye movements repeatedly suggest patient experiencing quality eye contact provide clues patient emotional state lack eye contact suggest depression mood affect distinction mood affect subject disagreement example baker describe affect external dynamic person internal emotional state mood person predominant internal state time refers affect differentiated specific feelings mood prolonged state disposition article use baker definitions mood regarded current state described patient affect quality patient emotional state based objective observation mood described patient words described summary terms neutral angry anxious individuals unable describe mood state individual unable experience pleasure suffering affect described apparent emotion conveyed person behavior anxious sad etc parameters intensity range mobility affect described appropriate inappropriate current situation thought content example shows bland affect describing experience described showing affect suggest intensity affect described normal affect exaggerated flat heightened overly dramatic flat affect associated depression post traumatic stress disorder heightened affect suggest overly dramatic exaggerated affect suggest certain personality disorders mobility refers extent affect changes interview affect described mobile fixed person range affect words wide range emotional expression assessment described having restricted affect affect described words changing appropriately flow conversation bland lack concern disability described showing feature conversion disorder historically termed older texts speech patient speech assessed observing patient spontaneous speech structured tests specific language functions heading concerned production speech content speech addressed thought form thought content observing patient spontaneous speech interviewer note comment features rhythm pitch quantity rate speech structured assessment speech includes assessment expressive language asking patient objects repeat short sentences produce words possible certain category set time simple language tests form mini mental state examination practice structured assessment receptive expressive language reported language assessment allow recognition medical conditions presenting conditions stroke presenting specific language disorders people syndrome pragmatic aspects speech repetition person words repetition subject words heard patients disease person use words specific meaning person speech assessment contributes assessment mood example people anxiety rapid loud pressured speech hand depressed patients typically prolonged speech speak slow quiet hesitant manner thought process thought process refers quantity tempo rate flow form logical thought thought process directly observed described patient patient speech tempo thought people experience flight ideas thoughts rapid speech careful observer chain poetic associations patient speech alternatively individual described having thinking thoughts progress slowly associations poverty thought global reduction quantity thought thought refers pattern person keeps returning limited set ideas pattern thought processes broadly referred formal thought disorder described specifically thought blocking fusion associations thinking thought knight thinking thought described patient includes great deal irrelevant detail makes frequent remains focused broad topic flight ideas typical conversely patients depression thinking poverty thought negative symptoms feature severe depression patient experience thought formal thought disorder common feature thinking observed anxiety disorders certain kinds personality disorders thought content description thought content describe patient ideas thought content established exploring individuals thoughts open ended manner regard intensity emotions associated thoughts extent thoughts experienced control degree belief conviction associated thoughts defined false idea belief keeping patient educational cultural social background held extraordinary conviction certainty core feature disorders patient described paranoid reference jealousy described mood content keeping mood typical mood content keeping mood typical control experiences individual experience mind body influence control kind external force agency typical examples include experiences thought withdrawal thought thought broadcasting rank symptoms set said highly suggestive diagnosis guilt poverty belief mind dead typical idea false belief held conviction intensity idea suffering illness idea body abnormal people idea overweight obsession unpleasant thought suppressed patient unlike experiences described experienced imposed outside patient mind typically thoughts violence injury dirt sex obsessive intellectual themes person describe doubt worries wrong decision forgotten example turn gas lock house obsessive disorder individual experiences sense having carry certain actions wishes object situation reality pose threat distinct patient aware fear usually highly specific certain situations usually reported patient observed assessment interview thoughts fixed false prominence person mind significant include thoughts suicide thoughts suspicious fearful beliefs associated certain personality disorders beliefs example failure anxiety depression contributes clinical risk assessment including thorough exploration hostile thought content assessment suicide risk includes detailed questioning nature person thoughts belief death reasons living person specific plans end life perceptions perception context sensory experience broad types disturbance defined sensory perception absence external experienced external objective space experienced subject real illusion defined false sensory perception presence external words distortion sensory experience recognized subject experienced internal space example voices head regarded akin fantasy sensory include distortion patient sense time example distortion sense self sense reality occur senses visual encountered frequently touch smell taste typical person voices talking patient hearing thoughts spoken aloud rank symptoms indicative second person voices talking patient threatening insulting telling commit suicide feature depression visual generally suggestive organic conditions drug drug withdrawal visual effects drugs correctly described visual visual sensory experiences experienced existing objective reality suggestive disorders associated temporal lobe disorders section covers patient level orientation attention memory functioning language functions executive functions unlike sections use structured tests addition observation global observation level consciousness awareness environment described alert orientation assessed asking patient example building town state time time day date attention concentration assessed serial test alternatively spelling letter word backwards testing digit span memory assessed terms immediate registration repeating set words short term memory recalling set words interval recalling short long term memory known historical geographical facts functioning assessed ability copy draw clock face draw map consulting room language assessed ability objects repeat phrases observing individual spontaneous speech response instructions executive functioning screened asking similarities questions common means verbal task list words starting letter minute mini mental state examination simple structured assessment widespread use component mild attention concentration occur mental illness people anxious including states extensive likely indicate gross disturbance brain functioning specific language associated area area brain syndrome dramatic memory relative preservation functions associated lobe executive functioning tests indicate frontal lobe kind brief testing regarded screening process carefully assessed formal testing include brief examination situations frontal lobe suggested person execute motor sequence paper stone posterior columns assessed person ability feel vibrations tuning fork lobe assessed person ability identify objects touch eyes closed disorder present person stand arms extended feet touching eyes closed sign person reaches object unable touch fixed point close eyes touch point basal indicated resistance movement limbs presence characteristic movements posterior detected asking patient roll eyes upwards syndrome focal signs reflect effects prescribed psychiatric chronic drug alcohol use head injuries brain disorders insight person understanding mental illness evaluated exploring explanatory account problem understanding treatment options context insight said components recognition mental illness compliance treatment ability label unusual mental events insight describe simply present absent report patient explanatory account impaired insight characteristic important consideration treatment planning assessing capacity consent treatment judgment judgment refers patient capacity sound reasoned responsible decisions traditionally included use standard hypothetical questions found stamped addressed envelope lying street contemporary practice patient responded respond real life challenges assessment account individual executive system capacity terms social self awareness planning ability impaired judgment specific diagnosis prominent feature disorders affecting frontal lobe brain person judgment impaired mental illness implications person safety safety cultural considerations potential problems applied cross cultural context patient different cultural backgrounds example patient culture different norms appearance behavior display emotions culturally spiritual religious beliefs need distinguished similar understand different roots assessment patient language educational background account racial bias potential children particular challenges carrying young children limited language people intellectual explore clarify individual use words describe mood thought content perceptions words different meaning assumed group tools play materials art materials instance multiple choices facial expressions depicting emotions facilitate recall explanation experiences
Mental status examination