This is a brief video on the mental status exam in psychiatry.
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ADDITIONAL TAGS:
Appearance: “general appearance of a patient, including apparent age, height, weight, and manner of dress and grooming.”
Eg, disheveled, proper/poor hygiene, appears (older/younger than) staged age
Behavior: “observations of specific abnormal movements, as well as more general observations of the patient's level of activity and arousal, and observations of the patient's eye contact and gait.”
Eg, (un)cooperative with exam, proper/poor eye contact, proper/poor engagement, repetitive movements (perhaps indicating OCD)
Motor: psychiatric disturbances manifesting in changes/deficiencies in motor function
Eg, psychomotor agitation, psychomotor retarded, tremors, restlessness (perhaps indicating parkinsonism)
Speech: “concerned with the production [rather than content] of speech”
Eg, speed, rate, volume, pressured, fluent/understandable versus impoverished speech, tone, delay/latency
Mood: description of patient's internal emotional state in their own words (report in quotes)
Eg, happy, sad, OK, good, great, depressed
Affect: description of patient’s “apparent emotion conveyed by the person's nonverbal behavior (anxious, sad etc.), and also by using the parameters of appropriateness, intensity, range, reactivity and mobility”
Eg, neutral, euthymic, dysphoric, euphoric, angry, anxious, apathetic, irritable, guarded, inappropriate (out of context)
Eg of range: flat (nothing elicits reactivity) → blunted → restricted / constricted (mild/moderate depression) → full / normal → labile / expansive (pt apparently not in control of emotions)
Congruence with reported mood
Thought process: description of “quantity, tempo (rate of flow) and form (or logical coherence) of thought”
Eg, linear, logical, goal-directed, disorganized, flight of ideas (thoughts so rapid → incoherent), tangential, circumferential
Tangential - thought process that goes off on a tangent and never returns to the matter at hand
Circumferential - thought process that goes off with extraneous details but does circle back to the matter at hand
Thought content: description of “a patient's delusions, overvalued ideas, obsessions, phobias, and preoccupations”
Eg, comments endorsing or denying suicidal ideations, homicidal ideations, and paranoid ideations; ideas of reference; any fixations or preoccupations
Perceptual disturbances: description of disruption in one’s organization, identification, or interpretation of sensory information
Eg, auditory / visual hallucinations and illusions, whether or not patient responds to them; other internal stimuli
Insight: understanding of his or her mental illness, evaluated by exploring his or her explanatory account of the problem and available treatment options
Eg, good, fair, poor
Judgement; patient's capacity to make sound, reasoned, and responsible decisions
Eg, good, fair, poor; (un)cooperative with plan, forced by family to come, handling treatment well/poorly
Memory: three words to remember for later
Concentration: ability to concentrate assessed by serial 7s or spelling world backwards
Orientation: to person (name, date of birth), place (state, town, current location/building/floor), time (season, year, month, date, day of the week)