Mental status examination

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Mental status examination

  1. 1. MENTALSTATUSEXAMINATIONMR. JAYESH PATIDARwww.drjayeshpatidar.blogspot.com
  2. 2. I. GENERAL APPEARANCE AND BEHAVIOUR(GAAB):a) Facial expression (Eg. Anxiety, pleasure, confidence,blunted, pleasant)b) Posture (stooped, stiff, guarded, normal)c) Mannerisms (stereotype, negativism, tics, normal)d) Eye to eye contact (maintained or not)e) Rapport (build easily or not built or built with difficulty)f) Consciousness (conscious or drowsy or unconscious)g) Behaviour (include social behaviour. Eg. Overfriendly,disinhibited, preoccupied, aggressive, normal)h) Dressing and grooming – well dressed / appropriate (toseason and situation) / neat and tidy / dirty.i) Physical features:- look older / younger than his or her age /underweight / overweight / physical deformity.www.drjayeshpatidar.blogspot.com
  3. 3. II. PSYCHOMOTOR ACTIVITY:(Increased / Decreased), Compulsive / echopraxia,Stereotype, negativism, Automatic obediencewww.drjayeshpatidar.blogspot.com
  4. 4. III. SPEECH: One sample of speech (verbatim in 2 or 3 sentences)a) Coherence – coherent / incoherentb) Relevance (answer the questions appropriately) – relevant/ irrelevant.c) Volume (soft, loud or normal)d) Tone (high pitch, low pitch or normal / monotonous)e) Manner – Excessive formal / relaxed / inappropriatelyfamiliar.f) Reaction time (time taken to answer the question) –increased, decreased or normalwww.drjayeshpatidar.blogspot.com
  5. 5. IV. THOUGHT:a) Form of Thought / formal thought disorder – (notunderstandable / normal / circumstantiality /tangentiality / neologism / word salad / perseveration /ambivalence)b)Stream of thought / flow of thought – (pressure of speech /flight of ideas / thought retardation / mutism / aphnoia /thought block / clang association.)c) Content of thoughta) delusion – specify type and give example – Persecutory /delusion of reference / delusions of influence or passivity /hypochondracal delusions / delusions of grandeur / nihilistic-Derealization / depersonalization / delusions of infidelity.b) Obsessionc) Phobiad) Preoccupatione) Fantasy – Creative day dreaming.www.drjayeshpatidar.blogspot.com
  6. 6. V. MOOD (Subjective) AND AFFECT(Objective):-a) Appropriate / inappropriate (Relevance to situation andthought congruent).b) Pleasurable affect – Euphoria / Elation / Exaltation /Ecstasyc) Unpleasurable affect – Grief / mourning / depression.d) Other affects – Anxiety / fear / panic / free floatinganxiety / apathy / aggression / moods swing / emotionalliability.www.drjayeshpatidar.blogspot.com
  7. 7. VI. DISORDERS PERCEPTION:a) Illusionb) Hallucinations – (specify type and give example) –auditory / visual / olfactory / gustatory / tactilec) Others – hypnogogic / hypnopombic / Lilliputian /kinesthetic / macropsia / micropsia.www.drjayeshpatidar.blogspot.com
  8. 8. VII.COGNITIVE FUNCTION:a) Attention and Concentration: Method of testing (asking to list the months of the yearforward and backward)b) Memory :a. Immediate (Teach an address & after 5 mts. Asking for recall)b. Recent memory – 24 hrs recallc. Remote – asking for dates of birth or events which areoccurred long backi) Amnesia / paramnesia / retrograde amnesia / anterogradeamnesiaii) Confabulationiii) ‘Déjà vu’ / Jamaes Vuiv) Hypermnesiawww.drjayeshpatidar.blogspot.com
  9. 9. Count…c) Orientation:1. Time - approximately without looking at the watch, whattime is it?2. Place – where he / she is now?3. Person – who has accompanied him or herd) Abstraction: Give a proverb and ask the inner meaning(Eg. Feathers of a bird flock together / rolling stonesgather no mass)e) Intelligence & General Information: Test by carry oversums / similarities and differences / and generalinformation / digit score test.www.drjayeshpatidar.blogspot.com
  10. 10. Count…f) Judgment :--Personal (future plans)-Social (Perception of the society)-Test (presents a situation and ask their response to thesituation)g) InsightI. Complete denial of illness.II. Slight awareness of being sick.III. Awareness of being sick attributes it to external / physical factor.IV. Awareness of being sick, but due to something unknown in himself.V. Intellectual insightVI. True emotional insightwww.drjayeshpatidar.blogspot.com
  11. 11. VIII.General Observation:a) Sleepi. Insomnia – temporary / persistentii. Hypersomnia – temporary / persistentiii. Non-organic sleep –wake cycle disturbanceiv. EMA – Early Morning Awakeningb) Episodic disturbances – epilepsy / hysterical /impulsive behaviour / aggressive behaviour /destructive behaviour.www.drjayeshpatidar.blogspot.com
  12. 12. IX. SUMMARY:www.drjayeshpatidar.blogspot.com
  13. 13. www.drjayeshpatidar.blogspot.com

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