The mental status examination focuses on evaluating a patient's current mental state by assessing their thoughts, feelings, and behaviors. It involves examining general appearance, mood, affect, speech, thought processes, sensory perceptions, orientation, memory, and higher cognitive functions. The goals are to establish a baseline, identify any problems, and facilitate accurate diagnoses.

1. By Eric F. Pazziuagan, RN, MAN

2. Mental Status Examination
 Focuses on the patient’s current state in
terms of thoughts, feelings and behaviors.
 An overall description of the client’s mental
status, including general appearance, mood
and affect, quality of speech, thought
content and processes, level of
consciousness and
cognition, impulsivity, ability to
abstract, judgment and insight, and
reliability.

3. Major goals:
 Gather baseline data about the
client’s level of functioning
 Identify actual and potential
problems
 Facilitate making accurate
psychiatric and medical diagnoses

5. Major Components:

6. General Appearance
 LOC
 Dress
 Facial expressions
 Posture
 Level of understanding
 Gait
 Grooming
 Psychomotor behavior or activity level
 Eye contact

7.  Attitude toward the nurse
 With whom and how the client arrived

8. Mood and affect
 Mood
 Pervasive and sustained emotional state that
depicts the client’s perception of the world
 Depressed
 Sad
 Labile
 Elated
 Expansive anxious

9.  Affect
 Present state of emotional responsiveness and is
observable with body language.
 Blunted
 Flat
 Restricted
 Depressed
 Expansive
 Angry
 Major point: whether thought is
congruent, appropriate, or both, with the mood and
affect.

10. Quality of Speech
 Speech
 Process of expressing
ideas, thoughts, and feelings through
language
 The use of words or language
 Involves physical descriptions of the
client’s speech

11.  Note:
 Quality and articulation
 Quantity and rate
 Other descriptions:
 Spontaneous
 Talkative
 Rapid
 Whispered
 Loud
 Stuttered
 Accent

12. Perceptual- Sensory Disturbances
 Hallucinations:
 False sensory perceptions of internal stimuli
 Can be visual, olfactory, auditory, or tactile
 Illusions
 Misinterpretation of external stimulus such as shadow
of the person
 Inquire about the content and the circumstances in
which they occur
 Consider cultural factors

13. Thought content and processes
 Thought content: what the client is thinking about
 Preoccupations: recurrent thoughts that center on a
particular idea or thought with an intense emotional
component.
 Obsessions: Maladaptive patterns of thoughts, images, or
feelings that generate anxiety.
 Compulsions: maladaptive urges to act on an impulse and
involve ritualistic behaviors such as excessive hand
washing.
 Delusions: fixed false beliefs and includes
persecutory, somatic, or jealous types
 Assess whether the client has homicidal or suicidal ideations

14.  Thought processes:
 Loose associations: flow of thoughts or ideas
unrelated to each other and shift from one
subject to another.
 Flights of ideas: rapid thinking ideas that have a
common theme.

15. Higher brain function
 Level of consciousness
 Orientation: refer to one’s sense of time, person, and
place.
 Memory: complex form of brain function that involves
storing and retrieving information that is later recalled
to consciousness.
 Remote (long term)
 Recent
 Recent past (current events)
 Immediate memory (short term)
 Immediate recall

16.  Concentration and attention: various conditions
produce disturbances, including delirium or other
medical anxiety or depressions.
 Cognition: ability to think and know
 Visuouspatial: refers to time and space
 Ability to read and write; consider:
 Cultural factors
 Educational preparations
 Previous level of functioning

17.  Ability to abstract: testing for concrete thinking
 Impulsivity: ability to control or manage various
urges appropriately.
 Judgment: ask “what if” questions
 Insight: involves the client’s understanding about
being ill and the need for treatment when
warranted.
 Reliability: whether the client’s perception of the
present problem and its history are credible.