Mental Status Examination

What are the key components of the mental status examination?

Appearance, behavior, motor activity, speech, mood, affect, thought process, thought content, perception, cognition, insight, and judgment.

In the mental status exam, what appearance aspects are assessed?

Clothing appropriate for weather, hygiene/grooming, and overall self-care.

What does 'behavior' refer to in the mental status exam?

Whether the patient is cooperative, agitated, or distressed, and the overall behavior observed.

What does 'motor activity' assess?

Posture and any involuntary movements, such as tremors, which may reflect neurologic disease or medication side effects (e.g., lithium).

What aspects of 'speech' are evaluated in the mental status exam?

Amount of verbalization, rate and tone, presence of slurred speech, and whether speech is pressured or rapid (as in mania).

How are 'mood' and 'affect' differentiated?

Mood is the patient's self-reported feeling; affect is the clinician's observed expression, which may align or not.

What should you evaluate about 'thought process and content'?

Whether thinking is organized/linear; presence of delusions; suicidal or homicidal ideation; safety considerations if suicidal.

What does 'perception' focus on in the mental status exam?

Presence of hallucinations, such as hearing voices; ask directly about perceptual disturbances.

What does 'cognition' assessment include?

Alertness and orientation; assessment of short-term and long-term memory.

What is 'insight' in this context?

Awareness of one's own illness and understanding of it.

What is meant by 'judgment' in the mental status exam?

Ability to make good decisions.

Why might clinicians perform a mini mental status examination in non-psychiatric settings?

To inform discharge planning and determine whether the patient can care for themselves or needs a higher level of care (e.g., skilled nursing or long-term care).

What safety action is indicated if a patient is suicidal?

Provide one-on-one observation to ensure the patient's safety.

How do mental status components relate to the general survey?

Some components are also part of the general survey (appearance, behavior, speech, hygiene) and can be observed during routine care.