Mental Health Assessment

What is mental health?

A state of well-being in which an individual realizes their abilities, copes with normal stresses, works productively, and contributes to the community.

What is mental status?

Level of cognitive and emotional functioning, including thinking, mood, behavior, and stability.

How is mental status inferred?

By evaluating behavior, appearance, speech, thought patterns, decisions, and ability to function.

What is a Mental Status Exam (MSE)?

Psychological equivalent of a physical exam that describes mental state and behavior.

What are the components of the MSE?

Appearance, Behavior, Cognition, Thought processes/perceptions, Insight/Judgment.

When is a full MSE required?

Behavioral changes, memory loss, anxiety, depression, aphasia, brain injury, acute psychiatric symptoms.

What is the Mini-Mental State Examination (MMSE)?

A 30-point cognitive screening tool used to detect delirium and dementia.

What is a normal MMSE score?

24-30 (27 is average).

What does the MMSE assess?

Cognitive functioning only.

What is the Montreal Cognitive Assessment (MoCA)?

A cognitive test sensitive to mild cognitive impairment.

What is a normal MoCA score?

≥ 26 out of 30.

Hypochondriasis

Worry about their own health

What is the SLUMS exam used for?

Screening cognitive function and mental status.

What is assessed under appearance?

Posture, body movements, dress, grooming, hygiene, pupil size and reaction.

What is normal posture?

Erect and relaxed.

What does behavior assessment include?

Level of consciousness, facial expression, speech, mood, and affect.

What is a normal level of consciousness?

Awake, alert, aware of stimuli, responds appropriately.

What is the difference between mood and affect?

Mood is subjective feeling; affect is outward emotional expression.

What does orientation assess?

Time, place, and person.

What indicates orientation to time?

Day, date, year, season.

What indicates orientation to place?

Location, address, city, state, building type.

What indicates orientation to person?

Name, age, and examiner identity.

What is attention span?

Ability to concentrate and complete thoughts without distraction.

What is recent memory?

Ability to recall new information or recent events.

How is recent memory tested?

24-hour diet recall, arrival time, delayed word recall.

What is remote memory?

Recall of verifiable past events.

What is remote memory impaired in?

Dementia and Alzheimer's disease.

What is the purpose of the Four Unrelated Words Test?

Assess new learning and short-term memory.

What is a normal Four Words Test result for those under 60?

Recalls 3-4 words at 5, 10, and 30 minutes.

What is aphasia?

Loss of ability to understand or express language due to brain injury.

What is insight?

Awareness of one's condition and situation.

What is judgment?

Ability to make safe and appropriate decisions.

What is thought process?

How a person thinks (logic and flow of ideas).

What is a normal thought process?

Logical, coherent, goal-directed.

What is circumstantial thinking?

Includes unnecessary detail but eventually reaches the point.

What is tangential thinking?

Goes off topic and never returns to the point.

What is thought blocking?

Sudden interruption of thought.

What are loose associations?

Disorganized, illogical connections between thoughts.

What is perseveration?

Repeating the same word or idea.

What is confabulation?

Fabrication of stories to fill memory gaps.

What is word salad?

Incoherent, disorganized speech.

What is thought content?

What a person thinks or talks about.

What is a delusion?

Fixed false belief not based in reality.

What is a grandiose delusion?

Exaggerated sense of power or importance.

What is a persecutory delusion?

Belief of being harmed or targeted.

What is a hallucination?

Sensory perception without external stimulus.

What is an illusion?

Misinterpretation of a real stimulus.

What do levels of consciousness range from?

Alert to coma.

What is lethargic?

Drowsy but easily aroused.

What is obtunded?

Difficult to arouse; responds to painful stimuli.

What is stupor?

Responds only to pain.

What is coma?

Completely unconscious with no response to stimuli.

What is the Glasgow Coma Scale (GCS)?

Tool used to assess level of consciousness.

What GCS score indicates coma?

8 or less.

What is cognition?

Process of thinking, reasoning, understanding, and remembering.

What are common causes of cognitive impairment in older adults?

Delirium, dementia, depression, medications, metabolic disorders.

What is delirium?

Acute, usually reversible disturbance in consciousness and attention.

What is a key feature of delirium?

Waxing and waning confusion.

What is the onset of delirium?

Rapid (hours to days).

What are common causes of delirium?

Infection, dehydration, medications, electrolyte imbalance, hypoxia.

What is dementia?

Progressive, irreversible decline in cognitive function.

What is an early sign of dementia?

Recent memory loss.

What is the most common cause of dementia?

Alzheimer's disease.

What does the Mini-Cog test include?

Three-word recall and clock-drawing test.

What is a normal Mini-Cog result?

Recalls three words and draws clock correctly.

What is depression?

Mood disorder lasting at least two weeks with loss of interest or pleasure.

What are depression risk factors?

Family history, female gender, stress, chronic illness.

What is the PHQ-2 used for?

Depression screening.

What is the PHQ-9 used for?

Assessing severity of depression.

What is suicidal ideation?

Thoughts or plans of self-harm.

What is the SAD PERSONS scale used for?

Suicide risk assessment.

What is generalized anxiety disorder (GAD)?

Excessive, unrealistic worry.

What is panic disorder?

Sudden intense anxiety with physical symptoms.

What is social anxiety disorder?

Fear of social situations.

What is post-traumatic stress disorder (PTSD)?

Anxiety disorder following trauma.

What is the GAD-7 used for?

Screening for anxiety disorders.

What is dysphonia?

Hoarseness or voice disorder.

What is dysarthria?

Slurred or slow speech due to motor impairment.

What is Broca's aphasia?

Expressive aphasia; understands language but struggles to speak.

What is Wernicke's aphasia?

Receptive aphasia; fluent but nonsensical speech.

What is global aphasia?

Severe impairment of expression and comprehension.

What is anomic aphasia?

Difficulty naming objects.

What is alexia?

Inability to read due to brain damage.