Mental Status Examination

General Appearance Affect

Note appearance, gait, dress, grooming (neat or Feeling tone associated with idea—labile, blunt,
unkempt), posture, gestures, facial expressions. Does appropriate to content, inappropriate, flat, la belle
patient appear older or younger than stated age? indifférence.

Motoric behavior Speech

Level of activity — psychomotor agitation or Slow, fast, pressured, garrulous, spontaneous, taciturn,
psychomotor retardation—tics, tremors, automatisms, stammering, stuttering, slurring, staccato. Pitch,
mannerisms, grimacing, stereotypes, negativism, apraxia, articulation, aphasia, coprolalia, echolalia, incoherent,
echopraxia, waxy flexibility; emotional appearance— logorrhea, mute, paucity, stilted.
anxious, tense, panicky, bewildered, sad, unhappy; voice
—faint, loud, hoarse; eye contact.
Perceptual disorders
Hallucinations—olfactory, auditory, haptic (tactile),
Attitude during interview gustatory, visual; illusions; hypnopompic or hypnagogic
How patient relates to examiner—irritable, aggressive, experiences; feelings of unreality, déjá vu, déjá entendu,
seductive, guarded, defensive, indifferent, apathetic, macropsia.
cooperative, sarcastic.
Thought content
Mood Delusions—persecutory (paranoid), grandiose, infidelity,
Steady or sustained emotional. state—gloomy, tense, somatic, sensory, thought broadcasting, thought
hopeless, ecstatic, resentful, happy, bashful, sad, insertion, ideas of reference, ideas of unreality, phobias,
exultant, elated, euphoric, depressed, apathetic. obsessions. compulsions, ambivalence, autism, dereism,
anhedonic, fearful, suicidal, grandiose, nihilistic. blocking, suicidal or homicidal pre-occupation, conflicts,
nihilistic ideas, hypochondriasis, depersonalization,
derealization, flight of ideas, idée fixe, magical thinking,
neologisms.
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Thought process Judgement
Goal-directed ideas, loosened associations, illogical, Ability to understand relationships between facts and to
tangential, relevant, circumstantial, rambling. ability to draw conclusions; response in social situations.
abstract, flight of ideas, clang associations,
perseveration.
Insight level
Realizing that there is physical or mental problem; denial
Sensorium of illness, ascribing blame to outside factors; recognizing
Level of consciousness— alert, clear, confused, clouded, need for treatment.
comatose, stuporous; orientation to time, place, person;
cognition.

Memory:
Remote memory (long-term memory)
Recent memory
Immediate memory (short-term memory)

Concentration and calculation

Ability to pay attention, distractibility, ability to do
simple math.

Information and intelligence

Use of vocabulary, level of education, fund of knowledge.

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