MENTAL STATUS EXAMINATION

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MENTAL STATUS EXAMINATION

• By
• Alan Sabu Thomas
• 1 PG Clinical Psychology

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Mental status Examination

• Clinicians use the term mental status examination
  to refer to what the clients thinks about and how
  the client thinks and acts
• Not present in a standardized form .
• Areas covered
• 1.Behaviour
• 2.Orientation
• 3.Content of thought.
• 4.Thinking style
• 5.Language
• 6.Affect and mood
• 7.Perceptual experience
• 8.Sense of self
• 9.Motivation
• 10.Intelligence
• 11.Inight

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APPEARANCE AND BEHAVIOUR

• Movement of the persons body
• Level of activity
• Hyperactivity
• Compulsion Repetitive and seemingly purposeful
  behavior that is performed in response to
  uncontrollable urges.

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ORIENTATION

• Its a persons awareness to time ,place and
  identity .
• People with mental disorders are disoriented.
• They are out of touch with the basic facts about
  themselves and their surrounding

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CONCENTRATION AND ATTENTION

• Reading and writing The patient is asked to read
  a sentence. He is also told to write a sentence
  in full and complete sentence.
• Visuospatial ability copying a figure exercise
  is done.
• Abstract thought Abstract thinking is the
  ability to deal with abstract concepts. Example
  similarities between truth and beauty. Answers
  could be overtly abstract or concrete. Brain
  damaged individual become extremely emotional and
  cannot think abstractly.

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AFFECT AND MOOD(affect outward expression of
emotional feeling)

• Feeling state becomes affect when others observe
  it.
• Mood refers to the experience of emotion the way
  the person feels inside.
• Assessment of mood important as it has got a lot
  of diagnostic and treatment significance
• Euthymic mood
• Dysphoric mood
• Euphoric Mood

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AREAS OF AFFECT

• Appropriateness of Affect The extent to which a
  persons emotional expressiveness fails to
  correspond to the content of what is being
  discussed.
• Intensity Degree of the affect
• Mobility Ease or speed with which people move
  from one kind of feeling or level of emotional
  intensity to other.
• Range- Refers to the broad range of affect and
  the ability to communicate sadness, anger
  ,agitation ,or calmness as the situation or
  discussion warrants

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COGNITIVE FUNCTIONING

• Sensorium and cognition Seeks to assess brain
  function ,including intelligence, capacity of
  abstract thinking, level of insight and judgment
  and insight .
• Consciousness Disturbance of consciousness
  indicate organic brain impairment.
• Clouding of consciousness Overall reduced
  awareness of environment ( frequently not as a
  fixed mental state)
• Altered state of consciousness show some
  impairment of orientation.
• Others states of consciousness include
  somnolence, stupor, coma ,lethargy, or alert

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INFORMATION AND INTELLIGENCE

• If the individual is suspected with cognitive
  impairment ,he or she would be asked to deal with
  mental task such as counting the change got after
  a purchase of 6.7 using a 10 note.
• Intelligence determined by
• 1.Word Vocabulary
• 2.General Fund of Knowledge
• 3.Educational level
• 4.Socioeconomic status
• Handling a difficult or sophisticated concept
  can reflect intelligence of an individual without
  formal education or extensive fund of knowledge.

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MEMORY

• Assessment of Memory is divided into four areas
• 1. Remote memory
• 2. Recent memory.
• 3. Recent past memory.
• 4. Immediate retention memory.
• 5. Recall
• Order of destruction of memory

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PERCEPTUAL EXPERIENCE

• Hallucinations False perceptions of not
  corresponding to the objective stimuli present I
  environment .
• Command Hallucination
• Visual Hallucination
• Olfactory Hallucination
• Somatic Hallucination
• Gustatory Halluciantion
• Illusions-Misinterpretation of a real object
  ,such as misperceiving a tree to be a man in the
  dark.

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CONTENT OF THOUGHT

• Important for assessment
• Takes place when the psychiatrist converses with
  the patient.
• Questions also asked Do you have anything in
  your head ,that you cannot bring out
• Important areas
• 1.Obsessions
• 2.Delusions
• 3.Magical thinking
• 4.Violent Ideation

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THINKING STYLE AND LANGUAGE

• Clues for thinking style and language ought to be
  found out
• Includes information on clients vocabulary
• Sentence structure
• Psychiatrist would have a tough time grasping
  words of a psychiatrist

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SENSE OF SELF

• A number of psychological disorder alter
  individuals identity or sense of who am I
• Depersonalization Refers to the an altered
  experiences of self ,such as feeling that ones
  body is not connected to ones mind.
• Identity Confusion Lack of sense of who one is.
• MOTIVATION
• Psychiatrist assess the motivation of client ,by
  assessing how strongly he or she desires a
  lasting personality change or relief of emotional
  distress.
• Some individual prefer to remain in their present
  rather than face their past or future.

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IMPULSIVITY

• Questions such as Is the patient capable to
  handle and manage sexual, aggressive, and other
  impulses ?
• Its important fro determining the awareness of
  socially appropriate behavior and a measure of
  patients potential danger to self and others.
• Impulse control can be estimated from the
  information in the patients recent history and
  from behavior observed during the interview.

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INSIGHT AND JUDGEMENT

• Attempts made by psychiatrists to know the degree
  to which individuals knows the nature of his/her
  disorder.
• Needs to get patients receptivity to the
  treatment.
• Insight, understanding and awareness about
  oneself and ones world.
• Judgment is intellectual process in which an
  individual considers and weighs the option to
  make a decision.

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THANK YOU