Mental Status Examination
I. General Appearance: Describe also manner of clothing (if appropriate to the occasion or not),
if subject looks appropriate to chronologic age
II. Behavior: tics/ mannerisms, eye contact
III. Attitude towards Examiner: Cooperative, guarded, uncooperative
IV. Mood: ASK: How do you feel? What is your mood today?
V. Affect: OBSERVE.
Range of affect: broad-ranged, constricted, blunted, flat
Appropriateness
VI. Speech: OBSERVE.
Spontaneous or not
Volume
Hypo-, normo-, hyperproductive
Pressured or not
VII. Perceptual disturbances: ASK
illusions
Hallucinations: visual, auditory, tactile, olfactory
VIII. Thought process: OBSERVE
Goal-oriented
Flight of ideas/ Looseness of associations
Circumstantiality/ tangentiality
IX. Thought content: ASK
Preoccupations
Ideations/ delusions
Suicidal/ homicidal ideations
X. Orientation
Time, place and person
XI. Memory
Immediate recall
Recent
Recent past
Remote
XII. Fund of knowledge
XIII. Attention/ Concentration
Serial 7s
XIV. Reading/ Writing
Write a sentence/ their name
Read a sentence
XV. Visuospatial ability
Interlocking pentagons or draw a clock
XVI. Ability to follow a three-step command
XVII. Abstract reasoning
Interpret proverbs
XVIII. Judgment
Ability to predict consequences of an action
Test judgment/ social judgment
XIX. Impulse control: OBSERVE
XX. Insight: ASK. What do you understand of your condition?
6 levels of insight
Levels of Insight
Level 1: Complete denial of illness
Level 2: Awareness of being ill, but denying it at the same time
Level 3: Awareness of being ill but blames illness on external factors
Level 4: Awareness of being ill but not knowing the cause
Level 5: Intellectual Insight
Level 6: True Emotional Insight