COMPONENTS OF MENTAL STATUS

EXAMINATION
GENERAL OBSERVATION
 COMPONENT DEFINITION/CONTENT WHAT TO ASSESS SAMPLE QUESTION/TEST POTENTIAL DIAGNOSES IF ABNORMAL

Appearance Body habitus, eye contact, Appearance: attention to detail, attire,
and Behavior interpersonal style, style of distinguishing features, grooming,
dress hygiene
Behavior: candid, congenial,
cooperative, defensive, engaging,
guarded, hostile, irritable, open,
relaxed, resistant, shy, withdrawn Eye
N/A Disheveled: depression, schizophrenia/psychotic
disorder, substance use
Irritable: anxiety
Paranoid: psychotic disorder
Poor eye contact: depression, psychotic disorder

contact: fleeting, good, none, sporadic Provocative: personality disorder or trait

Mood and Mood: subjective report of Body movements/making contact with How is your mood? Mood disorder, schizophrenia, substance use
Affect emotional state by patient others, facial expressions
Affect: objective observation of Have you felt sad/discouraged
patient’s emotional state by lately?
the physicia
Have you felt energized/out of
control lately?

Motor Activity Facial expressions, movements, Akathisia: excessive motor activity N/A Akathisia: anxiety, drug overdose or withdrawal,
posture medication effect, mood disorder, parkinsonism,
Bradykinesia: psychomotor retardation post traumatic stress disorder, schizophrenia

Catatonia: immobility with muscular Bradykinesia: depression, medication effect,

rigidity or inflexibility schizophrenia

Catatonia: schizophrenia/psychotic disorder,

severe depression
COGNITIVE FUNCTIONING
 COMPONENT DEFINITION/CONTENT WHAT TO ASSESS SAMPLE QUESTION/TESTS POTENTIAL DIAGNOSE IF ABNORMAL
ATTENTION Ability to focus based on - Count by sevens or fives Spell a word backwards Attention-deficit/hyperactivity disorder, delirium, dementia, mood
internal or external priorities disorder, psychotic disorder
EXECUTIVE Ordering and implementation Testing each cognitive function Clock drawing test: ask patient to draw a clock with hands Delirium, dementia, mood disorder, psychotic disorder, stroke
FUNCTIONING of cognitive functions necessary involved in completing a task set to 11:10 Trail-making test: ask patient to alternate
to engage in appropriate numbers with letters in ascending order
behaviors
GNOSIA Ability to name objects and - Show patient a common object and ask if he or she can Advance dementia, stroke
their function identify it and describe how it is used
LANGUAGE Verbal or written Appropriateness of N/A Rapid or pressured speech: mania
communication conversation, rate of speech (>
100 words per minute is Slow or impoverished speech: delirium, depression, schizophrenia
normal; < 50 words per minute
is abnormal), reading and Inappropriate conversation: personality disorder, schizophrenia
writing appropriate to
education level Inappropriate reading/writing level: dementia, depression,
previous stroke
MEMORY Recall of past events Declarative: recall of recent When is your birthday? Short-term deficit: amotivation, attention-deficit/hyperactivity
and past events Procedural: What are your parents’ names? disorder, dementia, inattention, substance use
ability to complete learned Where were you born?
tasks without conscious Where were you on September 11, 2001?
thought Ask patient to repeat three words immediately and again in
five minutes Ask patient to sign his/her name while
answering unrelated questions
ORIENTATION Ability of patient to recognize Time, space, person What year/month/day/time is it? Amnesia, delirium, dementia, mania, previous stroke, severe
his or her place in time and What city/building/floor/room are you in? depression
space What is your name?
When were you born?
PRAXIS Ability to carry out intentional praxia: inability to carry out Could you show me how to use this delirium, dementia, intoxication, stroke
motor acts motor acts; deficits may exist hairbrush/hammer/pencil?
in motor or sensory systems,
comprehension, or cooperatio