Elements of mental status exam

Abstract reasoning

Ask the client to interpret a proverb or identify a theme between 3 or 4 objects.

Helps assess reasoning and cognitive functioning.

Appearance

How does the client look? Well groomed? Age appropriate dress?

Attitude

Is the client cooperative, resistant or fearful?

Behavior

What is the client activity level? Tics or stereotyped movement? How alert is the client? Facial expressions and do they match the content discussed?

Mood/affect

What is the client's prevailing mood? Is there observable mood lability? Does the client show a range of affect? Is it appropriate to the content discussed?

Speech

is the client understandable? any speech abnormalities?

Thought process

Is the client's thought process circumstantial? Tangential? Is there evidence of flight of ideas? Is there poverty of thought? Perseverations?

Thought content

Does the client exhibit delusions? Phobias? Obsessions? Is the client preoccupied? Does the client have suicidal thought? Thoughts of harming others?

Perceptions

Is the client experiencing hallucinations or illusions?

cognition

is the client alert and oriented? can the client demonstrate attention and concentration? is the clients memory in tact?

Insight

does the client demonstrate understanding of his or her own symptoms or situation?

Judgement

Does the client demonstrate the ability to make sound reasonable decisions?