NCM 117
ECSTACY- intense feeling of pleasure (magical
Mental Status Examination
- a structured assessment of the patient's behavioral
and cognitive functioning. It includes descriptions
of the following:
o patient's appearance and general behavior,
o level of consciousness and attentiveness,
o motor and speech activity,
o mood and affect,
o thought and perception,
o attitude and insight,
o the reaction evoked in the examiner, and,
finally, higher cognitive abilities.
A. CONSCIOUSNESS
1. DISORIENATION- Confusion to time, person and
place
2. CLAUDED- Incomplete clear mindedness
3. DELIRIUM- Incomplete but the patient has
extreme fear and hallucination
4. STUPOR- Decrease loc but the patient
vigorously stimulated
5. COMA- profound decrease level of LOC
LOBES OF THE BRAIN
1. FRONTAL- personality behavior, attitude,
speech (Broca’s)
2. Parietal- pain, touch and temperature
3. Temporal- intelligence, sense of
understanding (Wernicke’s)
4. Occipital- control BP, sense of sight
B. AFFECT
1. INAPPROPRAITE- incongruent with the situation
2. LABILE- abrupt change in emotion/ oscillation of
emotion.
3. BLUNT- late reaction/ delayed reaction.
4. FLAT- absence/ near absence of emotion.
C. MOOD
1. EUTHYMIC- without mood disturbances. Normal
tranquil mental state or mood
2. DYSTHYMIC- abnormal range in mood
3. CYCLOTHYMIC- one cycle before changing in
mood (6 mos.)
4. DEPRESSION- intense feeling of hopelessness
and despair
5. EUPHORIA- feelings of elation (intense
happiness)
6.
thinking)
7. ANHEDONIA- lack of interest to activities,
inability to feel pleasure.
8. AMBIVALENCE- the coexistence of love and
hate toward a person or object Mixed
sensation/ feelings.
9. Avolition- lack/absence of motivation.
D. MOTOR FUNCTION
1. CATATONIC WITHDRAWAL- conscious
immobilization/ muscle relax.
2. CATATONIC RIGIDITY- characterized by stiff,
immobile postures that cannot be easily moved.
or with muscle contracted.
3. CATATONIC EXCITEMENT- purposeless
performance of an act (manic disorders.
Purposeless motor activity.
4. NEGATIVISM- motiveless resistance to all
attempts to be moved or to all instructions or
immobilization but someone attempts the
patient to move.
5. AUTOMATISM- automatic performance of an
act (robot like movement)
6. Somnambulism- abnormal motor function,
sleepwalking.
7. Compulsion- persistent action (OCD) ritualistic
behavior
8. WAXY FLERXIBILITY- maintenance of the same
posture for a long period of time. Having once
arms/ legs flexed or extended for a long period
smell,
of time.
E.THOUGHT CONTENT
1. Neologism- coining of new words
2. Clang association- Rhyming of words/
combining unrelated words or phrase.
3. WORD SALAD- Mixture of unrelated words to
one sentence.
4. VERBIGERATION- repetition of one’s own word.
Meaningless repetition of words/ phrase.
5. ECHOLALIA- repetition of words by others.
6. CIRCUMSTANTIALITY- going around the bush
but the patient answers the question.
7. TANGENTIALITY- going around the bush but not
answering the questions.
8. FLIGHT OF IDEAS- abrupt change of topic but
connection exist.
9. ASSOCIATIVE LOOSENESS- shift of ideas from
one unrelated topic to another.
 10. THOUGHT BLOCKING- stop at the middle of
conversation.
F. THOUGHT PROCESS-
1. Obsession- persistent, repetitive thought.
Recurrent and persistent thoughts, impulses, or
images that are experienced, at some time
during the disturbance. Common obsessions
include fears about contamination, worries
about having left appliances on or doors
unlocked, fear of acting in shameful or
humiliating ways, discomfort about things being
out of order, extreme concerns about
superstitions such as unlucky numbers or
colors, and excessive worries about keeping
objects.
2. DELUSION- false belief. Are characterized by an
unshakable belief in things that are not true.
a. Erotomanic- Someone with this type of
delusional disorder believes that
another person, often someone
important or famous, is in love with him
or her.
b. Paranoid Grandiose- A person with this
type of delusional disorder has an over-
inflated sense of worth, power,
knowledge, or identity.
c. Persecutory- People with this type of
delusional disorder believe that they (or
someone close to them) are being
mistreated, or that someone is spying
on them or planning to harm them.
d. IDEAS OF REFERENCE- sometimes called
a delusion of reference—is the false
belief that irrelevant occurrences or
details in the world relate directly to
oneself.
3. Jealous- A person with this type of delusional
disorder believes that his or her spouse or
sexual partner is unfaithful.
4. Somatic- A person with this type of delusional
disorder believes that he or she has a physical
defect or medical problem.
5. Mixed- People with this type of delusional
disorder have two or more of the types of
delusions.
G. SENSORY PERCEPTION
1.HYPOCHONDRIASIs- exaggeration of physical signs and
symptoms.
2.ILLIUSION- misinterpretation of external stimuli-A
perception that occurs when a sensory stimulus is
present but is incorrectly perceived and
misinterpreted, such as hearing the wind as someone
crying
3.HALLUCINATION- misinterpretation of senses without
external stimuli. Where someone sees, hears, smells,
tastes or feels things that don't exist outside their
mind.
a. Auditory Hallucination -are false perceptions
of sound.
b. Visual Hallucination- involve seeing things
that aren't there.
c. Olfactory Hallucination- (phantosmia) makes
you detect smells that aren't really present in
your environment.
d. Gustatory Hallucination- is similar to olfactory
hallucinations, but they involve your sense of
taste instead of smell. Tastes are often
strange or unpleasant.
e. Tactile Hallucination- an abnormal or false
sensation of touch or perception of
movement on the skin or inside the body
H. SPEECH
1. POVERTY- less talk -provides extensive verbal
feedback that contains little useful
information.
2. Pressured- sudden increase in the volume of
speech, when you talk faster than usual.
3. Motor Aphasia/ Expressive Aphasia/ Broca’s
aphasia inability to express. Inability to speak
or to organize the muscular movements of
speech.
4. Sensory Aphasia/ receptive/ Wernicke's -is
inability to understand spoken, written, or
tactile speech symbols that results from
damage of the brain.
5. Global Aphasia- combination of Broca’s and
Wernicke's
THERAPIES
1. PSYCHODRAMA- Involves the use of role
training, actions and group dynamics to
facilitate constructive change in the client’s life.
2. FAMILY THERAPY- A psychotherapy indicated
for treatment of family problems through
improved communication.
3. CRISIS INTERVENTION- Problem-solving
method aimed to assist the individual to
 develop new coping skills and return to the pre-
crisis level of functioning.
The aim of the treatment is to relieve the symptoms of
4. PLAY THERAPY- Therapeutic use of play to
some mental health problems.
provide opportunities to a child to experience
feelings and emotions in a safe environment.  To prepare the client for the procedure, the
5. REALITY THERAPY- Problem-solving method nurse should tell him/her that sleep will be
that focuses on the here-and-now of the client induced and treatment will not cause pain
to enable them to focus on changing their own
behaviors and thoughts.  The voltage of electrical current that is
6. BEHAVIOR THERAPY- Structured approach that administered to the client is between 70 and
reinforces an individual’s positive behavior. 150 volts.
7. GESTALT THERAPY- Involves encouraging  The electrical shock is applied to the client in
individuals to develop a sense of awareness of about 0.5-2 seconds
his/her feelings and behaviors and their effects
upon his/her environment in the present time.  The absolute contraindication to ECT is
8. RECREATIONAL THERAPY- Therapeutic process increased intracranial pressure.
that utilizes recreation to improve an
 The relative contraindications to ECT include:
individual’s quality of life.
fever, cardiac arrythmias, TB with history of
9. OCCUPATIONAL THERAPY- Incorporates
hemorrhage, recent fracture, retinal
meaningful and purposeful occupation to
detachment and pregnancy (with
enable people with limitation and impairment
complications).
to participate in the activities of everyday life.
10. MUSIC THERAPY- The prescribed use of music  The therapeutic effects of ECT become evident
to effect positive changes in an individual with in one week.
health or educational problem.
11. COGNITIVE THERAPY- Involves identifying
thinking (irrational thoughts) and learning and
replacing it with more realistic ideas.
12. HORTICULTURAL THERAPY- Use of plants and
plant-related activities to improve mobility,
balance, endurance, socialization and memory
skills.
13. RE-MOTIVATION THERAPY- Simple group
therapy that focuses on client’s abilities and
enables them to think about reality in relation
to themselves.
14. ART THERAPY- Therapeutic use of art-making to
increase awareness of self and others, cope
with stress, trauma and enhance cognitive
abilities.
15. VOCATIONAL THERAPY- Process that involves
assessment of skills and provision of vocational
training to enable an individual with a mental
health problem to have a job.
16. ELECTROCONVULSIVE THERAPY- is a treatment
that involves sending an electric current
through your brain, causing a brief surge of
electrical activity within your brain (also known
as a seizure).