Mental Status Exam Terminology

clinical stuff

Demographics

• name

• DOB

• Age

• ethnicity

• religious preferences

• gender

Orientation

Do they know who, where, why they are here?

• person, place/ situation, time/day/date

Alertness

a place of consciousness where one is alert and ready to respond to stimuli, versus when one is unaware or tired.

Can they answer these questions?

• consciousness

• stupor

• memory

Appearance

How does the patient look during the interview?

• health

• clothing

• posture

• gait

• hygiene

Speech

The way the patient speaks, the quality and quantity of speech

• rate

• tone

• fluency

Rate of Speech

Slow, Normal, Rapid, Mute

Tone of Speech

Soft, Loud, Clear, Monotonous

Fluency of Speech (Characteristics)

• Sarcastic

• Confabulation

• Clang Associations

• Slurred

• Hostile

• Neologisms

• Echolalia

• Rhyming

• Word Salad

Sarcastic Speech

The use of words that mean the opposite of what you really want to say, especially in order to insult someone, to show irritation, or to be funny

Confabulation Speech

the spontaneous production of false memories: either memories for events which never occurred, or memories of actual events which are displaced in space or time

Clang Associations

are groupings of words, usually rhyming words that are based on similar sounding sounds, even though the words themselves dont have any logical reason to be grouped together

Slurred Speech

Omission, reduction or substitution of words

Hostile Speech

Behaving in a very unfriendly or threatening way towards someone

Neologisms speech

A new word that is coined especially by a person affected with schizophrenia and is meaningless except to the coiner

Echolalia

the pathological, parrot-like, and apparently senseless repetition (echoing) of a word or phrase just spoken by another person

Rhyming Speech

to have or end with the same sounds

Word Salad

Incoherent speech consisting of both and imaginary words, lacking comprehensive meaning, and occurring in advanced schizophrenic states

Intellect

the patient’s basic knowledge and awareness of social events

Mood (Objective)

Is a generalized, internal state of feeling sustained over a prolonged period of time that can alter an individual’s perception of the world

Mood Characteristics

• Dysthymic

• Calm

• Suspicious

• Consistent with thoughts

• Happy

• Anxious

• Elated

• Ashamed

• Fluctuating Moods

• Apathetic

• Angry

• Frightened

Dysthymic Mood

depressed mood may be mild, moderate or severe

Calm Mood

A state of peace and tranquility

Suspicious Mood

Cautious distrust of someone or something

Happy Mood

Feeling pleasure and enjoyment

Elated Mood

very happy or proud; jubilant; in high spirits

Ashamed Mood

Feeling inferior, inadequate, or embarrassed

Apathetic Mood

Feeling or showing no interest, enthusiasm or concern

Angry Mood

Furor, Fury, Indignation, Irate

Frightened Mood

Making you feel fear

Affect (subjective)

the observed expression or experience of emotions, feelings and moods

Affect characteristics

• Flat

• Fearful

• Intense

• Blunted

• Euphoric

• Full Range

• Labile

• Congruent

• Bright

• Limited Range

• Agitated

• Expansive

Flat Affect

• lack of emotional expression

Blunted Affect

a reduction in the intensity of an individual’s emotional response

Euphoric Affect

a feeling of happiness, confidence or well-being sometimes exaggerated in pathological states such as mania

Labile Affect

characterized by rapid changes in emotions unrelated to external events or stimuli

Congruent Affect

psychotic content consistent with patient’s mood

Agitated Affect

Easily angered, irritated

though processes

the way the patient puts ideas together, the association between the ideas

Thought Processes Characteristics

• Tangential

• Circumstantial

• Slow

• Linked

• Blocking

• Rapid

• Coherent

• Flight of Ideas

• Coherent

• Impoverished

• Thought Broadcasting, Withdrawal, Insertion, Control

• Alien Control

• Suicidal Ideation

• Self-harm

• Delusions

• Obsessions

• Over-Valued Ideas

• Homicidal Ideation

Tangential Thought Process

a disturbance in the associative thought process in which one tend to digress readily from one topic under discussion to other topics

Circumstantial Thought Process

a pattern of speech that is indirect and delayed in reaching its goal because of excessive or irrelevant detail

Slow Thought Process

Exhibit slow speech or difficulty understanding and registering information

Blocking Thought Process

a sudden obstruction or interruption in spontaneous flow of thinking or speaking perceived as an absence or deprivation in thought

Rapid Thought Process

a failure to be able to “think straight.” Thoughts may come and go rapidly. the person may or may not be able to concentrate on one thought for very long and may be easily distracted, unable to focus attention

Coherent Thought Process

Capable of logical and consistent speech and thought

Flight of Ideas Thought Process

A rapid succession of thoughts manifested by continuous and constantly shifting verbalized or loosly linked play on words.

the ideas are generally connected

Impoverished Thought Process

Characterized by brief and empty replies to questions

Thought Broadcasting

the belief that others can hear or are aware of an individual’s thoughts

Thought withdrawal

the delusion that someone or something is removing thoughts from one’s mind

Thought Insertion

the delusion that thoughts are being placed into one’s mind by an outsider

alien Control

the belief that one’s thoughts or actions are being controlled by outside alien forces

Suicidal Ideation

thinking about killing one’s self

Self-harm

injuring one’s self on purpose

Obsessions

an idea or thought that continually preoccupies or intrudes on a person’s mind

Over-Valued Ideas

a solitary, abnormal belief that is neither delusional nor obsessional in nature, but which is preoccupying to the extent of dominating the sufferer’s life

Homicidal Ideation

Thinking of taking another’s life

Thought Content

ideas the patient communicated, ideas about themselves and the World

Thought Content Characteristics

• Delusions

• Hallucinations

• Insight

Delusions

a belief that is not true, a false idea, a fixed false belief that is resistant to reason or confrontation with actual facts.

Grandiose Delusions

an exaggerated belief or claim of one’s important or identity manifested by delusion of wealth, power or fame

Nihilistic Delusions

a persistent denial of existence of particular things or of everything including oneself.

• a person who has such a delusion may believe that they live in a shadow or limbo world Or that they died several years ago and that only the spirit in a vaporous form really exists

Religious Delusions

that you are Jesus, God, Prophet or the Anti-Christ

Bizarre Delusions

delusion that is patently absurd with no possible basis in fact

Persecutory Delusions

a delusion that one is being attacked, harassed, cheated, persecuted or conspired against

Passivity delusions

belief that impulses, actions, or feelings are controlled by an external force

Illusions Delusions

Sensory experience misinterpretation in context of a real stimulus

Hallucinations

a profound distortion in a person’s perception of reality

Hallucination Characteristics

• auditory

• visual

• tactile

• olfactory

• kinesthetic

• coenesthetic

• gustatory

• command

Kinesthetic Hallucination

a hallucination involving the sense of bodily movement when motionless

Coenesthetic Hallucination

the patient reports that they feel bodily functions that are usually undetectable

• like the formation of urine or the movement of internal organs.

Reliability

the degree to which a test produces similar scores each time it is used. Stability or consistency of the scores produced by an instrument

• How consistent are the client’s answered?

Judgement

the capacity of you, the examiner, to form an opinion by evaluating the data you gathered.

• Do you believe the client is at risk for anything?