MENTAL STATUS EXAMINATION

Possible Descriptors (O)/Possible Questions for client (I)

Components
Appearance Observed

Gait, posture, clothes, grooming

Wears gray shirt, gray shorts and indoor slippers, clothing is
appropriate with the weather, sitting 2 feet away from student
nurses; appears clean and undisturbed, maintains eye contact
Appearance Observed during the span of the interaction; with clean and trimmed
fingernails and toenails; hair is kempt, facial expression
appropriate to mood set in conversation; appears congruent to
stated age, endomorph; slumped posture, no body or breath odor
noted.

Mannerisms, gestures, psychomotor activity, expression, eye

contact, ability to follow commands/requests, compulsions.
Hands were held together, occasionally smiles, maintains good
Behavior Observed eye contact, able to follow commands/requestion. Cooperative
and manageable. Seemed comfortable to answer some
questions having limited responses at first but as conversation
progressed, patient started opening up about his thoughts, plans,
reason why he was admitted, his substance abuse etc.

Cooperative, hostile, open, secretive, evasive, suspicious,

Attitude Observed apathetic, easily distracted, focused, defensive
Cooperative, open, focused

Level of Observed Vigilant, alert, drowsy, lethargic, stuporous, asleep, comatose,

Consciousness confused, fluctuating
Alert

Orientation Inquired “Please state your full name.”

(to person, time, “Where are we at (floor, building, city, county, and state)?” “What
place, situation/ is the full date today (date, month, year, day of the week, and
circumstance) season of the year)?”
“How would you describe the situation we are in?”
Ako si ______, ari kita subong sa Center for the Mentally Ill sa
General Luna St. Subong nga adlaw sabado, November 26, 2022.
Nag occupational therapy kita subong.

Speech and Observed Quantity- Talkative, spontaneous, expansive, paucity, poverty

Language
Rate- Fast, slow, normal, pressured
Volume(Tone)- Loud, soft, monotone, weak, strong
Fluency and Rhythm- Slurred, clear, with appropriately placed
inflections, hesitant, with good articulation, aphasic
Mood Inquired “How are your spirits?” “How are you feeling?”
( A sustained state Verbalized enjoyment and focus during the making of the card.
of inner feeling)
“Have you been discouraged/ depressed/ low/ blue lately?” “Have
you been energized/elated/high/out of control lately?” “Have you
been angry/irritable/edgy lately?”
He is annoyed because he cannot exercise because of the
small space of their room.

Affect Observed Appropriateness to situation, consistency with mood,

congruency with thought content.
(An observed
expression of inner Fluctuations: Labile, even
feeling)
Range: Broad, restricted
Intensity: Blunted, flat, normal intensity
Quality: Sad, angry, hostile, indifferent, euthymic, dysphoric,
detached, elated, euphoric, anxious, animated, irritable

Thought Observed/ Linear, goal-directed, circumstantial, tangential, loose

Process/Form Inquired associations, incoherent, evasive, racing, blocking,
(logic, relevance, perseveration, neologisms.
organization, flow
and coherence of
thought in response
to general
questioning during
the interview)

Thought Content Observed/ “What do you think about when you are sad/angry?”
Inquired
Want to punch brother.
“What’s been on your mind lately?”
Wants to exercise.
“Do you find yourself ruminating about things?”
No.
“Are there thoughts or images that you have a really difficult time
getting out of your head?”
“Are you worried/scared/frightened about something or other?”
“Do you have personal beliefs that are not shared by others?”
(Delusions are fixed, false, unshared beliefs.)
“Do you ever feel detached/removed/changed/different from
others around you?”
“Do things seem unnatural/unreal to you?”
“What do you think about the reports in papers such as The
Philippine Daily Inquirer?”
 “Do you think someone or some group intend to harm you in some
way?”
[In response to something the patient says] “What do you think
they meant by that?”
“Does it ever seem like people are stealing your thoughts, or
perhaps inserting thoughts into your head? Does it ever seem like
your own thoughts are broadcast out loud?”
“Do you ever see (visual), hear (auditory), smell (olfactory), taste
(gustatory), and feel (tactile) things that are not really there, such
as voices or visions?” (Hallucinations are false perceptions)
No.
“Do you sometimes misinterpret real things that are around you,
such as muffled noises or shadows?” (Illusions are misinterpreted
perceptions)

Suicidality and Inquired Suicidality

Homicidality
“Do you ever feel that life isn’t worth living? Or that you would just
as soon be dead?”
“Have you ever thought of doing away with yourself? If so, how?”
“What would happen after you were dead?”
No.
Homicidality
“Do you think about hurting others or getting even with people who
have wronged you?”
No.
“Have you had desires to hurt others? If so, how?”
Yes. “Gusto ko sumbagon akon magulang kay di ya ko
pagpagwaon.”

Insight and Observed/ “What brings you here today?”

Judgment Inquired
May Occupational Therapy kita.
“What seems to be the problem?”
“Nadakpan ako nga mangawat sang scrap. Tapos ginpasakay
sa patrol kag gindala diri.”
“What do you think is causing your problems?”
“How do you understand your problems?”
“How would you describe your role in this situation?”
“Do you think that these thoughts, moods, perceptions, are
abnormal?”
“How do you plan to get help for this problem?”
“What will you do when __________ occurs?”
 “How will you manage if _____________ happens?”
“If you found a stamped, addressed envelope on the street, what
would you do with it?”
“If you were in a movie theater and smelled smoke, what would
you do?”
Matawag bombero.” Upon further asking, he said “matawag
bomber kay may kalayo kay may aso.”

Attention Span Observed/ Suggested patient instructions:

(Attend, Inquired
Digit Span (forward and reverse)
concentration,
distractibility “I will recite a series of numbers to you, and then I will ask you to
repeat them to me, first forwards and then backwards.” [Begin with
3 numbers – not consecutive numbers, and advance to 7-8
numbered sequence.]

Spelling Backwards
“Spell the word ‘world.’ Now spell the word ‘world’ backwards.”
Able to spell the word and backwards.
Calculations
(Serial 7’s) “Starting with 100, subtract 7 from 100, and then keep
subtracting 7 from that number as far as you can go.”
(Serial 3’s) “Starting with 20, subtract 3 from 20, and then keep
subtracting 3 from that number as far as you can go.” [Monitor for
speed, accuracy, effort required, and monitor patient reactions to
the request]
Able to subtract 3s in succession, starting from 20. Was only
able to do 3 subtractions, answering until 11. Refused to
further perform the calculations saying “Di na ako kabalo.” A
little slow in answering, seems deep in thought before
answering.
“Add these numbers: (15 + 12 + 7)”
“Multiply these numbers: (25 x 6)”
“If something costs 78 cents and you give the cashier one dollar,
how much change should you get back?

Memory Observed/ Recent Memory

Inquired
“What is my name?”
“Ikaw si Josephine kag siya naman si Patricia.”
“What medications did you take today?”
Biperiden.
“What time was your appointment with me for today?”
 Remote Memory
“Where were you when President Kennedy was shot?” (For
patients over 40)
“What is your Social Security number?”
“What were the dates of your graduation from high school,
college, graduate school?”
High School Graduation: 2012.
“When and where did you get married?”

Immediate Memory and New Learning (Suggestedpatient

instructions)
“I am going to ask you to remember three words (color, object,
animal – e.g., blue, table, and horse) and I will ask you to repeat
them to me in 5 minutes. Please repeat them now after me: blue,
table, and horse.” – 5 minutes elapse – “What were those three
words I asked you to remember?” [Monitor accuracy of response,
awareness of whether responses are correct, tendency to
confabulate or substitute other words, ability to correct themselves
with category clue and multiple choice].
Able to recall only 3 out 3 random words (kalo, ballpen,
papel) when asked to repeat them a few minutes after it was
enumerated by the SNs. Recalled and mentioned kalo,
ballpen, papel.

Intellectual Observed Information and Vocabulary

functioning
/Inquired “Name the last 5 presidents.”
“Name 5 of the largest cities in the country.”
“Name the current president, vice president, governor, and
mayor.”
Named the President, Vice President, and Mayor.
Vocabulary - Grade school level, high school level, fluent,
consistent with education.

Abstraction
Similarities – “How are the following items similar?”
“an apple and an orange” (round - concrete, fruit - abstract) “a
chair and a table” (made of wood - concrete, furniture - abstract)
“a watch and a ruler” (measurement instruments - abstract)
“orange and basketball ball”
“pareho color, ginahampangan, bilog”
Proverbs – “How would you describe the meaning of the following
sayings?”
“People living in glass houses should not throw stones.”
“A bird in the hand is worth two in the bush.”
“You shouldn’t cry over spilt milk.”
“Two heads are better than one.”
Mas nami ang isa kaysa sa duwa, kay isa lang pakan-on mo.”
“Aanhin pa ang damo kung patay na ang kabayo?”
Patay ang kalibutan kay patay ang kabayo.