Mental Status Exam

Question 1

(Patient at rest)
- Age/gender, younger/older than stated age, body habitus, type of clothing, hygiene (e.g., smelling of alcohol, urine, feces, cigarette smoke, etc.), grooming, physical abnormalities (e.g., pupil size, bruises, needle marks/tracks, cuts, teeth, etc.), tattoos, body piercings

Answer 1

General Appearance

Question 2

(Patient in action)
- Posture, eye contact, mannerisms, tics, activity level, psychomotor retardation/activation.

Answer 2

Behavior

Question 3

Inner restlessness with inability to stay still.

Answer 3

Akathisia

Question 4

Spontaneous verbal or motor behavior without patient awareness.

Answer 4

Automatism

Question 5

Extreme motor inactivity or hyperactivity.

Answer 5

Catatonia

Question 6

Involuntary combination of chorea (irregular migrating contractions) and athetosis (twisting/writhing).

Answer 6

Choreoathetosis

Question 7

Twisting/repetitive movement or abnormal fixed posturing.

Answer 7

Dystonia

Question 8

Unintentional, rhythmic, oscillatory movement.

Answer 8

Tremor

Question 9

(Patient interaction)
- Cooperative/uncooperative, seductive, flattering, charming, eager to please, entitled, controlling, hostile, guarded, critical, antagonistic, childish

Answer 9

Attitude

Question 10

Patient reported emotional tone in quotations. Equivalent of chief complaint.

Answer 10

Mood

Question 11

Physical expression of a person’s immediate feeling state, typically focusing on facial expression

Answer 11

Affect

Question 12

Normal display of emotion.

Answer 12

Euthymic

Question 13

Intense display of emotion.

Answer 13

Hyperthymic

Question 14

In ​an excited state of intense happiness.

Answer 14

Elevated / Euphoric

Question 15

In a profound state of unease or dissatisfaction.

Answer 15

Dysphoric

Question 16

Easily annoyed or angry.

Answer 16

Irritable

Question 17

Feeling worried or nervous, ​typically over an uncertain future outcome.

Answer 17

Anxious

Question 18

Depth and range of feelings shown.
- Intense > Full > Constricted > Blunted > Flat

Answer 18

Quality / Range

Question 19

Shifting of emotional states.
- Labile > Supple/Stable > Sluggish

Answer 19

Motility

Question 20

Appropriate or not appropriate.

Answer 20

Appropriateness to content​

Question 21

Rate, rhythm, articulation

Answer 21

Speech

Question 22

Pressured > Rapid > Regular > Slowed
Pressured speech: Rapid, frenzied speech driven by an internal sense of urgency.

Answer 22

Rate

Question 23

Prosody, cadence, latency (pauses before speaking), spontaneity (ability to make small talk)

Answer 23

Rhythm

Question 24

Dysarthria, stuttering
Accent/dialect, tone, volume/modulation (loudness/softness)

Answer 24

Articulation

Question 25

A mechanical dysfunction with speech.

Answer 25

Dysarthria

Question 26

Meaningless repetition of another person’s spoken words.

Answer 26

Echolalia

Question 27

Making up of new words.

Answer 27

Neologism

Question 28

Groupings of words (usually rhyming), based on similar-sounding sounds, regardless of logical grouping.

Answer 28

Clang associations

Question 29

Goal-directed/logical, Circumstantial, Tangential, Loosening of associations, Flight of ideas, Perseveration, Thought blocking

Answer 29

Thought Process

Question 30

Linear progression of thought without veering from subject at hand.

Answer 30

Goal-directed/logical

Question 31

Inability to answer a question without giving excessive, unnecessary detail. Does eventually return to the original point.

Answer 31

Circumstantial

Question 32

Wandering from the topic and never returning to it or providing the information requested.

Answer 32

Tangential

Question 33

Incoherent slippage of ideas further and further from point of discussion.

Answer 33

Loosening of associations

Question 34

Rapid shift from one topic to another.

Answer 34

Flight of ideas

Question 35

Repetition of a particular response (e.g., word or phrase), regardless of the absence or cessation of a stimulus.

Answer 35

Perseveration

Question 36

Abrupt cessation of speech without explanation in the middle of a sentence

Answer 36

Thought blocking

Question 37

Poverty of thought, Overabundance of thought, Delusions, Depersonalization, Derealization, Illusion, Hallucination, Obsession & Compulsion, Phobia, Suicidal & Homicidal ideations

Answer 37

Thought content

Question 38

A global reduction in the quantity of thought.

Answer 38

Poverty of thought

Question 39

A global increase in the quantity of thought.

Answer 39

Overabundance of thought

Question 40

Fixed, false beliefs that do not change even when presented with evidence counter to them, and are outside of cultural, societal or religious norms.

Answer 40

Delusions

Question 41

Delusion that one’s bodily function, sensation or appearance is abnormal.

Answer 41

Somatic delusion

Question 42

Delusion of possessing superior qualities such as fame, wealth or supernatural powers.

Answer 42

Delusion of grandeur

Question 43

Delusion of mistreatment, usually persecution (e.g., being spoken about behind one’s back, “people are out to get me”).

Answer 43

Paranoid delusion

Question 44

Delusion ​where an otherwise insignificant event is misconstrued as having special significance specifically to oneself.

Answer 44

Delusion of reference

Question 45

Delusion ​where one believes one's thoughts to be externally placed from an outside party.

Answer 45

Delusion of thought insertion

Question 46

Delusion ​where one believes one is being controlled by an outside party or parties, and self-control is lost.

Answer 46

Delusion of thought control

Question 47

Delusion ​where one's thoughts are made known to everyone in the outside world.

Answer 47

Delusion of thought broadcasting

Question 48

Delusion where one believes that prominent figures or superstars are in love with or in a relationship with oneself, when that is not the case in reality.

Answer 48

Erotomanic delusion

Question 49

Delusion where one believes that nothing is real. This is in contrast to derealization or depersonalization, which have more to do with an altered reality, not the lack of it.

Answer 49

Nihilistic delusion

Question 50

Loss of all sense of identity, wherein one's thoughts and feelings are no longer felt to be one's own.

Answer 50

Depersonalization

Question 51

A change in the perception or experience of the external world to where it feels unrealistic.

Answer 51

Derealization

Question 52

A misinterpretation of existing stimuli.

Answer 52

Illusion

Question 53

A perception perceived in the absence of any existing stimuli.

Answer 53

Hallucination

Question 54

A hallucination experienced before falling asleep.

Answer 54

Hypnagogic hallucination

Question 55

A hallucination experienced upon waking up from sleep.

Answer 55

Hypnopompic hallucination

Question 56

Repeated intrusive and unwanted thoughts, images or urges.

Answer 56

Obsession

Question 57

Repetitive behavior or mental acts in response to obsessions.

Answer 57

Compulsion

Question 58

Persistent fear or an object or situation.

Answer 58

Phobia

Question 59

Thoughts of, or preoccupation with, suicide.

Answer 59

Suicidal ideation

Question 60

Thoughts of, or preoccupation with, homicide.

Answer 60

Homicidal ideation

Question 61

Awareness/understanding of situation, illness and available choices - Full > Partial/limited > None

Answer 61

Insight

Question 62

Patient’s decision-making ability (based on HPI and recent behavior) - Excellent > Good > Fair > Poor

Answer 62

Judgement

Question 63

General consciousness, Orientation, Attention, Language, Calculation, Right hemisphere, Abstraction, Memory, Praxis

Answer 63

Cognition

Question 64

Alert > drowsy > lethargic > stuporous > comatose

Answer 64

General consciousness

Question 65

x4 (person, time, place, situation)

Answer 65

Orientation

Question 66

WORLD backwards, serial 7s from 100

Answer 66

Attention

Question 67

Name objects, repeat words/sentences

Answer 67

Language

Question 68

Ability to add/subtract

Answer 68

Calculation

Question 69

Intersecting pentagons, clock-face

Answer 69

Right hemisphere

Question 70

Explain similarities between objects, understand simple proverbs

Answer 70

Abstraction

Question 71

Immediate (repeat after me), short-term (what were the words?)

Answer 71

Memory

Question 72

Engage, applying, exercising, realizing or practising ideas

Answer 72

Praxis