What is mental status?
A person’s emotional (feeling) and cognitive (knowing) function, assessed by consciousness, language, mood/affect, orientation, attention, memory, abstract reasoning, thought process, thought content, and perceptions.
When is a mental disorder apparent?
When a person’s response is much greater than the expected reaction to a traumatic life event.
What is the purpose of a full mental status exam?
To systematically check emotional and cognitive functioning, determine mental health strengths/coping skills, and screen for dysfunction.
When is a full mental status exam required?
- Brief screening suggests anxiety or depression
- Family notes behavior changes (e.g., memory loss, inappropriate interaction)
- Organic symptoms (wandering, poor concentration, judgment issues, language difficulty)
- Cognitive/emotional changes with brain lesions
- Aphasia or emotional problems
- Acute psychiatric symptoms
What factors should every mental status exam consider?
Patient’s physical illnesses, medications, educational/behavioral level, and personal history responses.
What are the 4 main components of a mental status assessment?
Appearance, Behavior, Cognition, and Thought processes (A, B, C, T).
What do you observe to assess appearance?
Posture, body movements, dress, grooming, hygiene, and pupils.
What do you evaluate to assess behavior?
Level of consciousness, facial expression, speech/articulation, mood, and affect.
What do you assess for cognition?
Orientation, attention span, recent/remote memory, new learning, and (for aphasia) word comprehension, reading, and writing.
What do you assess for thought processes?
Thought process, content, perceptions, plus screening for anxiety, depression, and suicidal thoughts.
What additional component should be assessed in a mental status exam?
Judgment—health-related rationales should be realistic.
What does the Mini-Mental State Exam measure?
Cognitive functions (visuo-constructive ability, language, memory, auditory attention, conceptual thinking, working memory, calculations, speech/language), not mood or thought processes.
What develops over time in infants/children that affects mental status?
Consciousness, language, attention span, and abstract thinking.
What does pediatric mental status assessment focus on?
Behavioral, cognitive, and psychosocial development in coping with the environment.
How can the ABC(T) method be used for children/adolescents?
Same as adults, but adapted for developmental milestones.
What are common childhood mental disorders?
ADHD, autism spectrum disorder, oppositional defiant disorder, and eating disorders.
How does aging affect mental status?
Mental status mostly intact, but slower response time may affect new learning; vision/hearing deficits may interfere.
What should you do before assessing an older adult’s mental status?
Check and correct sensory deficits.
What tool is used for testing consciousness in older adults?
Glasgow Coma Scale.
What tool screens for cognitive impairment in older adults?
Mini-Cog.
