Mental State

Question 1

How do you assess Appearance?

Answer 1

Eye contact?
Facial expression?
Unusual / inappropriate clothing?
Do they look physically well?
Level of consciousness?
Any striking / distinguishing features?
Are they neat, tidy, clean? Unkempt, dishevelled?
Any smells?

Question 2

How do you assess Behaviour?

Answer 2

How are they behaving?
Is it appropriate?
Are they friendly? Suspicious? Hostile?
Overfamiliar? Anxious?
Fidgeting or sitting still?
Pacing around the room?
Tics or mannerisms?
Banging the table? Singing?
Or withdrawn?

Question 3

How do you assess Speech?

Answer 3

Rate and quantity
Flow and rhythm
Volume and tone
Pressured / difficult to interrupt?
Slow?
Mute?
Do they make sense?
Neologisms? (schizophrenia)

Question 4

How do you assess Mood?

Answer 4

Subjective - how does the patient describe it?

Objective - how do they appear to you? Appropriate to circumstances? Changeable?

Question 5

How do you assess Thought Form?

Answer 5

how thoughts are linked together
Evidence of loosening associations where thoughts don’t link together? Tangential?
Not answering the question?
Flight of ideas?

Question 6

How do you assess Thought Content?

Answer 6

Any delusions?
Any pre-occupations eg guilty thoughts, health anxiety
Obsessions?
Phobic symptoms?
Overvalued ideas?

Question 7

How do you assess Risk?

Answer 7

Suicidal thoughts? Plans?

Thoughts to harm others?

Question 8

How do you assess Perception?

Answer 8

Any hallucinations? Describe in detail eg modality (visual, auditory, tactile), who is involved, how many

Question 9

How do you assess Cognitive?

Answer 9

Separate full cognitive assessment

Question 10

How do you assess insight?

Answer 10

Does the patient think they are unwell?
What do they think is wrong?
Are they prepared to accept treatment?

Question 11

What order should the components be tested?

Answer 11

1. Appearance
2. Behaviour
3. Speech
4. Mood
5. Thought form
6. Thought content
7. Risk
8. Perception
9. Cognitive
10. Insight