MENTALSTATUSEXAMI

NATI
ON

Cl
i
nical
assessmentofcogni
ti
vef
unct
ioni
ngoft
hecl
i
enti
ncl
udest
hear
easof
:-

 Or
ient
ati
on

 At
tent
ion&concent
rat
ion

 Memor
y

 I
ntel
l
igence

 Abst
ract
ion

 Judgement

 I
nsi
ght

ORI
ENTATI
ON
Thr
eeaspect
sar
edescr
ibedt
oti
me,
placeandper
son.
Thef
oll
owi
ngquest
ionsmaybeaskedi
nther
elev
antar
eas:
-
TI
ME:
-
1)Appr
oximat
elywhatti
meofthedayisit(
ift
hecl
i
enti
sunabl
etor
epl
y,a
morespeci
fi
cquest
ioncanbeasked)
2)I
sitmorni
ng,af
ter
noon,eveni
ngorni
ght?(
Inaddi
ti
onf
urt
herquest
ioni
ng
maybedonetoassessest
imati
onoft
ime)
3)Approximatel
y how l
ong i s i t since y ou had y our
breakfast
/l
unch/
tea/
dinner
? OR appr
oxi
mat
ely how l
ong hav
e Ibeen
tal
kingtoyou?
4)Whati
sthedayt
oday
?(dayofweek)
5)Whati
sthedat
etoday
?
PLACE:
-
1)Whatplacei
sthi
s?(
ift
heansweri
snotf
ort
hcomi
ng,
aspeci
fi
cquest
ioni
s
asked)
2)I
st hi
saschool,of
fi
ce,hospi
tal
,rest
aurantet
c.(i
fthecli
entsay
sthi
sa
hospi
tal
,det
ail
smaybeaskeddependingonthebackgr
ound)
 PERSON:
-
1)Or
ient
ati
ont
osel
fist
est
edbyaski
ngt
hei
dent
it
yoft
hecl
i
ent
.
2)I
nqui
ri
ngaboutt
hei
dent
it
yoft
hecl
i
ent
’sr
elat
ivesorf
ami
l
ymember
s.

ATTENTI
ONANDCONCENTRATI
ON
Test
susedi
ncl
i
nical
sit
uat
ioni
ncl
ude:
-
1.Thedi
gitspant
est
2.Ser
ial
subt
ract
ion
3.Day
sormont
hsf
orwar
dorbackwar
d

DI
GITSPANTEST
DigitFor
ward-cli
entisgi
venthef ol
l
owinginst
ructi
ons-“
Iwil
lbesayi
ngsomedigi
ts,
l
istentomecar eful
l
y.WhenIf i
nishsayi
ngthem, y
ouwi l
lhav
etorepeatt
hem i
nthe
sameor der
.Theexami neraf
terinstr
uct
ingthecli
ent:
a)Gi
vesanexampl
e(f
oreg.I
fIsay3-
7,y
ousay3-
7)
b)Readsdi
git
sast
her
ateofonepersecondt
othecl
i
ent
c)Noteswhet
hert
heimmedi
ater
esponseoft
hecl
i
enti
scor
rectori
ncor
rect
.
Thefol
lowi
ngdi
git
smaybeused:

3-
7 9-
2
7-
4-9 1-
7-4
8-
5-2-
7 5-
2-9-
7
2-
9-6-
8-3 6-
3-8-
5-1
5-
7-2-
9-4-
6 2-
9-4-
7-3-
8
8-
1-5-
9-3-
6-2 4-
1-9-
2-7-
5-1
3-
9-8-
2-5-
1-4-
7 8-
5-3-
9-1-
6-2-
7
7-
2-8-
5-4-
6-7-
3-9 2-
1-9-
7-3-
5-8-
4-6

Thedigi
tspanisthehi
ghestnumberofdigitsrepeatedcorrectl
y.Thesamedigi
ts
shoul
dnotberepeatedmorethanonce.Iftheclientcannotrepeatapart
icul
ar
nd
numberofdigi
tsononetri
al,
a2 t r
ial
withthesamenumberofdi gi
tsi
sgivenand
cr
edi
tisgi
veni
fther
esponsei
scor
rect
.
Di
gitbackwar d-cl
ientisgi
v enthef
oll
owi ngi
nstr
ucti
ons-“Iwi
llbesayingsome
di
git
s,li
stentomecar ef
ull
y.WhenIf i
nishsayi
ngthem,y ouwil
lhavetorepeatt
hem
i
nar eversedorder,f
oreg,ifIsay2-
5,youhav etosay5-2.Theprocedurei
sthesame
asfordigitf
orward.Thefollowi
ngdigit
smaybeused:
7-
1 3-
4
6-
2-9 4-
7-5
8-
2-7-
9 4-
9-6-
8
6-
5-8-
4-3 1-
5-4-
8-6
5-
3-7-
4-1-
8 7-
2-4-
8-5-
6
8-
1-4-
9-3-
6-2 4-
7-3-
9-6-
2-8
9-
4-3-
7-6-
2-1-
8 7-
2-8-
1-5-
6-4-
3

Thedigi
tbackwardscor
eist
hehighestnumberofdi
git
scor
rect
lyr
ecal
l
ed
backwar
dsafteramaximum of2tr
ial
s.

SERI
ALSUBTRACTI
ONTEST
I
ncr easinglydi
fficul
ttest
sarepresented.Theexami
nera)i
nst
ruct
sthecli
ent,
b)givest hecli
ent,examplesofhowt operfor
mt het
ask,
c)not
estheresponses
verbatim, and,d)notestheti
met akeninseconds
TASK:
Cor
rectr
esponseandt
hel
i
mit
20-
1 20t
o0r
ever
sedi
n15seconds
40-
3 40,
37,
34,
31et
cin60seconds
100-
7 100,
93,
86,
79,
etci
n120seconds

DAYSORMONTHS
Daysormonthsmaybeaskedf
orwar
dorbackwar
dst
othecl
i
entwhoi
sfami
l
iar
wit
hthecor
rector
der
.

MEMORY
Assessmenti
ncl
udei
mmedi
ate,
recentandr
emot
ememor
y.
a)I
mmedi
atememor
y-t
est
edbydi
gitspan
b)Recentmemor ytest
edby -i
)aski
ngtheclienttorecal
levent
sinthel ast24hour
s
e.g.,
detai
lsoftheti
meandamounti nameal , vi
sit
orstothehospit
alfrom an
i
npat i
ent.Responsesgivenbythecl
ientshouldbenot edandcrosscheckedfrom
reli
ablesource.
i
i)Addr esstest
-anaddressconsist
ingofabout4-5factswhi
chisnotknowntot he
cli
ent,i
sslowlyreadt
otheclientaft
erinst
ruct
inghi
m/ hert
oattendtotheexaminer
.
He/ sheisengagedinconver
sation(toavoi
drehearsal
)andtheresponsei
snoted
verbati
m.
c)
Remot
ememor
y-El
i
citi
nfor
mat
iononl
i
feev
ent
s:
i
)Dat
eofbi
rt
horage
i
i
)Numberofchi
l
dren
i
i
i)Namesandnumberoff
ami
l
ymember
s
i
v)Ti
mesi
ncemar
ri
ageordeat
hofanyf
ami
l
ymember
v
)yearofcompl
eti
ngeducat
ion

ABSTRACTI
ON
Test
edbysi
mil
ari
ti
es,
dif
fer
encesandpr
over
bs.

 Simi
l
ari
ti
es-thecli
entisgi
venthefoll
owi
nginstr
uct
ions“Iwil
lbegi
vingy
ou
somepairofwords.Youhavetotel
lmeinwhatwayar etheyali
ke,
whatis
commonbet weenthem,orwhatisthesi
mil
arit
ybetweenthem.
Or
ange-
banana(
frui
ts)
Dog-
li
on(
ani
mal
s)
Ey
e-ear(
senseor
gans)
Nor
th-
west(
dir
ect
ions)
Tabl
e-chai
r(i
temsoff
urni
tur
e)
Cor
rectr
esponsei
.e.abst
ractr
esponsesar
egi
veni
nbr
acket
s.

 Dif
ferences-Beinganeasiert
askisalwayspresent
edbeforesimil
arit
ies.The
i
nstructi
onsareasf ol
lows“Iwil
lbepresent
ingtoyousomepai rsofthe
words.Listentothem car
eful
lyandtel
lmeinwhatt heyar
et heydi
fferent
fr
om eachot her.
 St
one-
pot
ato(
notedi
ble-
edi
ble/
har
d-sof
t)
Fl
y-
but
ter
fl
y(smal
l
-lar
ge/
notcol
orf
ul-
col
orf
ul)
Ci
nema-
radi
o(audi
ovi
sual
-v
isual
)
I
ron-
sil
ver(
heav
y-l
i
ght
/dul
l
-br
ight
)
Pr
aise-
puni
shment(
posi
ti
ve-
negat
ive/
pleasant
-unpl
easant
)

 Pr
over
bs–t
hecl
i
enti
saskedt
hef
oll
owi
ngquest
ions:

a)Whet
herheknowswhatapr
over
bis?
b)Anexampl
eofapr
over
bandwhati
tmeans
Ifi
tiscl
eart
hatt
hecl
i
enthasaconceptofpr
over
b,t
hef
oll
owi
ngmaybe
asked:
i
) Sl
owandst
eadywi
nst
her
ace
i
i
) Don’
tcr
yov
erspi
l
ledmi
l
k
i
i
i) Anappl
eadaykeepst
hedoct
oraway
i
v) Act
ionsspeakl
oudert
hanwor
ds
Notethecl
i
ent’
sresponseandcheckwhetherabst
ract
ioni
sataconcr
ete,
funct
ional
,
concept
uall
evel
ortherei
sover-
abstr
act
ion.

GENERALI
NTELLI
GENCE
Thisincl
udest
hear
easofgener
ali
nfor
mat
ion,
compr
ehensi
on,
ari
thmet
icand
vocabular
y.

I
NFORMATI
ON
I
nfor
mat
ionr
elev
antt
othecl
i
ent
’sl
i
ter
acy
,ageoroccupat
ionmaybeasked:
Exampl
e–f
orl
i
ter
ate:
i
) Nameoft
hepr
imemi
nist
er
i
i
) 5r
iver
s,ci
ti
esorst
ates
i
i
i) Capi
tal
sofcount
ri
es
i
v) Cur
rentev
ent
s(maj
or)
Fori
l
li
ter
ates:
 i
) Seasons
i
i
) Cr
opsorf
rui
tsgr
owi
ngi
npar
ti
cul
arseason
i
i
i) Pr
icesoff
oodgr
ainsorf
oodi
tems
i
v) Pr
icesofl
and

COMPREHENSI
ON
Thef
oll
owi
ngquest
ionsofi
ncr
easi
ngdi
ff
icul
tymaybeasked:
1)Whatwi
l
lyoudowheny
ouf
eel
col
d?
2)Whatwi
l
lyoudoi
fitr
ainswheny
oust
artt
owor
k?
3)Whatwi
l
lyoudowheny
oumi
sst
hebuswheny
ouar
eonaj
our
ney
?
4)Whatwil
lyoudowheny oufi
ndoutony
ouwayt
hati
twi
l
lbel
atebyt
het
ime
your
eachy ourwor
kpl
ace?
5)Whyshoul
dwebeawayf
rom badcompany
?

ARI
THMETI
C
Thef
oll
owi
ngquest
ionsmaybeaskedwi
thi
ncr
easi
ngt
imeuni
ts:
1.Howmuchi
s4r
upeesand5r
upees?
2.I
fIborr
owed6r
upeesf
rom af
ri
endandr
etur
ned2r
upees,
howmuchdoIst
il
l
owetohim?
3.I
famanbuysclot
hesfor12rupeesandgi
vest
heshopkeepera20r
upeenot
e,
howmuchchangewouldhegetback?
4.Howmanypencil
scany
oubuyf
or2r
upeesi
fonepenci
lcost
squar
terofa
r
upee(
or25paise)?
5.I
f18boy
sar
edi
vi
dedi
ntogr
oupsof6,
howmanygr
oupswi
l
lther
ebe?
Quest
ions1t
o3-15seconds
Quest
ions4&5-30seconds
Cor
rectanswer
s-1)9,
2)4,
3)8,
4)8,
5)3

VOCABULARY
Gi
vet
hef
oll
owi
ngi
nst
ruct
ionst
oyourcl
i
ent
:“Iam goi
ngt
oseehowmanywor
dsdo
youknow.Tellmenowforexampl
e,whatCYCLEmeans.Whatisacycl
e?”I
f
responsei
svague,t
henquesti
onf
urt
her,f
orexampl
e-“
whatelsedoesi
tmean?
Explai
nali
ttl
emore”.
Agoodresponsei
swhenthecli
entcangiveagoodsynonym,amaj oruse,
oneor
morepr
imaryfeat
ures,
agenet
iccl
assif
icat
ionorl
essdefi
nit
ivebutcorr
ect
cumul
ati
vedescri
pti
on.
Testwor
ds: Goodr
esponses
Cy
cle i
thaswheel
s,y
our
ideoni
t
Kni
fe i
sshar
p,usedt
ocut
Shoe madeofl
eat
her
,weari
t
Umbrel
l
a f
orr
ain,
sun.Putov
ert
hehead,
isr
ound
wi
th
ahandl
e
Let
ter postcar
d,wr
it
etoaf
ri
end,
Mi
schi
ef naught
y,f
ool
i
ng,
troubl
esomeone
Gol
d pr
eci
ousmet
al,
isv
eryv
aluabl
e,make
or
nament
s
Cl
ever smar
t,cannotbet
ri
ckedorf
ool
ed,
bri
ght
Edi
tor sel
ect
sforpubl
i
cat
ionorwr
it
es
edi
tor
ial
s

JUDGEMENT
1)PERSONAL-assessedbyaskingf
utur
epl
ansoft
hecl
i
ent
,hi
s/herper
sonal
expect
ati
onsandatti
tudes.
2)SOCI
AL-thecli
ent’
sinter
acti
onwit
hthei
nterv
iewerandotherf
amil
ymember
s
i
sassessed.Usual
lyassessedf
rom t
hehi
storygi
venbytheinf
ormant
s.
3)TEST-a)whatshoul
dyoudoi
fyoufi
ndast
amped(
notcancel
l
ed)and
addr
essedenvel
opelyi
ngont
heroad?
b)
whatshoul
dyoudoi
fyouseesmokeorf
ir
einagr
ocer
yst
ore?