Guide to Clinical Examination/Mental status examination

The mental status exam is one of the most important tests in psychiatry. This will be a basic guide to performing one.

Observational Components

• Appearance: What is the patient's clothing like? Is it appropriate for the environment? (IE, wearing a parka in July, or almost nothing when it is snowing) Is their clothing overly flashy or disorganised? Do they seem to pay attention to grooming?
• Level of alertness: Are they conscious? Catatonic? Delirious?
• Speech: Is it normal in terms of quantity, rate, and tone? Racing, loud, constant speech may be a sign of mania, while a noticeable decrease in the amount of speech may indicate a depressive illness.
• Behavior: Are they behaving appropriately for the situation? Be sure to remember that people from different cultures behave differently. Are they agitated, uncooperative or unpleasant?
• Orientation: Are they oriented x3? (Time, location, self)
• Affect: How do they appear to feel to you? do they show no outward emotions, or do they switch and exaggerate them?
• Thought process: is their thinking organised? do they show signs of derailment, flight of ideas, or other thought disorders?

Directly Inquired Components

• Mood: How do they claim to feel? Does that emotion make sense given their current situation?
• Thought Content: Are there delusions? Hallucinations? Suicidal or homicidal ideation?
• Memory: Simple basic tests of short and long term memory
• Higher Reasoning: Can they interpret idioms and similar non-concrete ideas? Frequently, they are asked to explain the phrase "People who live in glass houses shouldn't throw stones".