Mental state examination

Appearance

• Reveals hygiene

 

Attitude

• Engagement with healthcare staff.

 

Behaviour

• Eye contact
• Gait
• Agitation

 

Mood

• Patients own words

 

Affect

• Blunted affect
• Exaggerated affect

 

Speech

• Rhythm
• Pitch
• Volume
• Rate

 

Thought process

• Flow
• Logical coherence

 

Thought content

Delusions 

Overvalued ideas

Obsessions

Phobias

Suicidal thoughts

 

Perceptions

• Hallucinations

 

Cognition

Alertness

• Responsiveness to environment

Orientation

• Location
• Time and date

Attention

• Digit span test - Ask them to repeat a sequence of numbers. Increase the sequence length each time.
• Digit span test backwards - Ask them to repeat the numbers in reverse order.

Memory 

• Immediate registration 
• Short-term memory
• Long-term memory

 

Insight

• Does patient believe they are ill?

 

Judgement 

• Does patient make sensible decisions?