Mental Status Examination

Question 1

Sustained Muscle contractions, which can cause twisting or abnormal postures. E.g. cervical dystonia (torticollis or twisted neck)

Answer 1

Dystonia

Question 2

Involuntary, repetitive movements of the face, mouth, and tongue. Common movements include lip smacking, tongue thrusting, chewing, and grimacing. It is a movement disorder that can develop as a side effect of long-term use of antipsychotic medications.

Answer 2

Tardive dyskinesia

Question 3

Sudden, recurrent, and nonrhythmic actions which may be vocal and/or motor

Answer 3

Tics

Question 4

Brief and purposeless movements that usually involve the face and neck (e.g. eye blinks, shoulder shrugs) and less often involve the extremities (e.g. hopping)

Answer 4

Motor tics

Question 5

Sudden, repetitive involuntary sounds, for example, brief grunts, coughing sounds, howling or barking-like noises, or more elaborate vocalizations that sometimes include obscene words (coprolalia)

Answer 5

Vocal tics

Question 6

Involuntary, repetitive, rhythmic movements such as rocking, swaying, hand-flapping, and head banging

Answer 6

Stereotypic Movement

Question 7

An objective observation of the patient’s emotion (physician observation of facial expressions, body language, and tone of voice)

Answer 7

Affect

Question 8

Sad, mournful (e.g., the patient may exhibit slow movements; low speech volume; and/or break into tears easily)

Answer 8

Depressed

Question 9

Inability to fully engage with their own feelings or the feelings of others; inability to be empathetic (e.g., the patient does not appear to display empathy or form emotional connections)

Answer 9

Detached

Question 10

Normal, tranquil mood (e.g. the patient appears calm and at ease)

Answer 10

Euthymic

Question 11

Positive, elated mood (e.g. the patient appears overly excited, joyful, or exhilarated)

Answer 11

Euphoric

Question 12

Easily annoyed or made angry; agitated

Answer 12

Irritable

Question 13

Sudden and frequent changes in expressed emotions (e.g. the patient may quickly change from a sad to a happy mood)

Answer 13

Labile

Question 14

Decreased facial and vocal expressions and decreased expressive gestures in reaction to emotion-provoking stimuli; emotional responses to situations and events are dulled (e.g. the patient may lack an intense emotional response to distressing topics)

Answer 14

Blunted

Question 15

No emotional responses to situations and events; no facial and vocal expressions and no expressive gestures in reaction to emotion-provoking stimuli (e.g., the patient lacks an emotional response to distressing topics)

Answer 15

Flat

Question 16

Repetitions in speech or prolongations in speech; the patient may repeat sounds syllables, or words (e.g., may-may-may-may-maybe); or prolong sounds in a word (e.g., m-m-m-maybe)

Answer 16

Dysfluent

Question 17

Unusual changes in pitch, intonation, stresses, phrasing, and rhythm in speech (e.g., the patient may chant or use a sing-song melody or use monotonic speech or question-like infection for matter-of-fact statements)

Answer 17

Dysprosodia

Question 18

Automatic repetition of somebody else’s words (e.g. the patient may repeat words or phrases used by the physician either immediately or after a delay)

Answer 18

Echolalia

Question 19

Speech that contains word-retrieval errors, common seen in patients who have a disorder of language (i.e, aphasia) after brain injury

Answer 19

Paraphasia

Question 20

The incorrectly retrieved word is similar in meaning to the intended word (e.g., “boat” instead of “beach”

Answer 20

Semantic paraphasia

Question 21

The incorrectly retrieved word is similar in sound based on syllable omissions/additions (e.g., “feletant” for “elephant”)

Answer 21

Phonemic paraphasia

Question 22

The incorrectly retrieved word is a new word that is not similar in sound or meaning to another word (e.g., “drupong” for clock)

Answer 22

Neologistic paraphasia

Question 23

Poorly elaborated speech (e.g. the patient may fail to answer questions or give only monosyllabic responses)

Answer 23

Poverty of speech

Question 24

Abundant non-stop speech (e.g., the patient may be difficult to interrupt)

Answer 24

Pressured

Question 25

Inappropriately formal speech (e.g., the patient may use pompous, legalistic, or overly intellectual terms and phrases)

Answer 25

Stilted

Question 26

Omission of connecting words, prepositions, and modifiers when speaking, similar to an old telegraph (e.g., the patient may say, “bad sleep month” in response to a query about sleep habits)

Answer 26

Telegraphic

Question 27

Indirect and winding speech in which the patient gives unnecessary and often irrelevant details before arriving at the main point; “beating around the bush” The patient eventually responds to a query but belatedly and with frequent parenthetical remarks

Answer 27

Circumstantial

Question 28

Characterized by poor topic adherence; the patient provides an answer to a question that veers off from the topic of the question and does not return to the original topic but there is a logical connection between responses

Answer 28

Tangential

Question 29

Rapidly jumping (“flight”) from topic to topic without completing each train of thought, often (but not always) expressed through rapid, pressured speech.

Answer 29

Flight of Ideas

Question 30

No logical connection between ideas and the loss of an overall sense of goal-directedness. The words make sentences, but together the sentences do not make logical sense (the thought train is “off the track”)

Answer 30

Derailed

Question 31

An association of words or ideas based on the similarity of sound rather than meaning (e.g., rhyming)

Answer 31

Clanging (clang association)

Question 32

Words that are created by the patient and do not have any meaning to others (Ex. klipno for boots)

Answer 32

Neologistic

Question 33

Repetitive thought process in which regardless of topic or question the patient goes back to the same topic and cannot move past the topic resulting in loss of goal-directedness in their thinking (e.g., patient often repeats previous statements in response to new questions)

Answer 33

Perseverative

Question 34

A belief that someone holds with absolute certainty, but this belief is at odds with reality; fixed, false beliefs (e.g. a belief that you are the Queen of England)

Answer 34

Delusional

Question 35

Preoccupation with distressing memories, thoughts, or worries with the hopes of obtaining new insight (the patient may repeatedly discuss a recent conflict in hopes of obtaining new insight); such goal-directedness is better preserved in ruminative thinking than in perseverative thinking. Furthermore, ruminations refer to the content of one’s thoughts, whereas perseverations refer to the process of one’s thinking

Answer 35

Ruminative

Question 36

A persistently recurring thought, urge, or image that is experienced as intrusive and unwanted and results in marked anxiety or distress

Answer 36

Obsessional