HUBERT KAIRUKI MEMORIAL
UNIVERSITY
FACULTY OF MEDICINE
DEPARTMENT OF BEHAVIORAL SCIENCE
COURSE;BEHAVIORAL SCIENCE
TOPIC:MENTAL STATUS EXAMINATION
FACILITATOR : ISACK LEMA
GROUP MEMBERS
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MELUBO NYANGE
MUHAJIRI MOHAMED BIYA
MARYAM MGIMBA
LIMBU SINGA GILYA
GEOFREY MAZIKU
JERINA
OBJECTIVES
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-To understand mental status examination
-To be able to assess mental disorders
-To understand how to apply mental status
examination test in solving mental disorders
Outline
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.Definition of Terms
.Introduction
.Main body
.Summary
.Conclusion
.Recommentation
.Reference
Definition of Terms
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Affect-the observed expression of emotion
Catatonia-A severe disturbance of motor functions
ussualy indicated by decreased activity
Circumstantiality-Talking more around a point
before finally getting to it
Compulsion-repetitive behaviour which the person
feels compelled to perfom
Depersonalization-A subjective sense of being unreal
strange or unfamiliar
Definitions of Terms
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Derealization-A subjective sense that the enviroment
is strange or unreal
Insight-refers to borth the individual’s awarness of a
problem or illness and to the nondelusional
understanding of its causes
Judgement-the process of forming an opinion or
conclusion based on information about a situation
and recognize the important elements of an issue
Introduction
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Mental status examination is a clinical assessment of the
individual which reflect borth individual’s subjective
report and experience, and the clinicians observations
at the time of interview. Its used to establish a baseline,
evaluate the change over time, facilitate diagnosis, plan
effective care and evaluate response to treatment.
Like any clinician mental status examination is one which
enhanced through practice, clinal supervision and
feedback. This learning package will be helpful to you
as you acquare knowledge to conduct this important
clinical skills.
Main body
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There is variations in how clinicians organize and
conducts the assessment. However the following
content areas should be addressed in any
comprehensive assessment of the mental status.
APPEARANCE, ATTITUDE AND
BEHAVIOUR
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Describing Appearance
Appearance can provide valuable clues to a
person’s mood, cognitive state, self awareness,
presence of the thought disorders, motor condition
and general physical health. Description of
appearance in mental status examination should
include unusual physical characteristics(shaved
head,tattoos), approximate height and weight
(obesity or thinness), hygien, level of eye contact,
and fascial expression in relation to thought content.
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Describing Attitude
in describing attitude we consider borth
individual’s attitudes towards the interview and
interviewer. The individuals attitude may influnce the
conents of informations obtained and may pose
special challengs to an intrviewer.
The clients attitude towards the interviewer may be
described in terms such as cooperative or
uncooperative, defensive, hostile or threatening.
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Describing Behaviour
description of behaviour should provide a mental
image of a person during the interview. The
documentation of behaviour in mental status
examination should include abnormalities in the level of
behaviour, any abnormal or involuntary motor activities
or behaviour, repeated or distinictive behaviour. Its
important to describe actual behaviour( e.g constantly
wringing hands) rather than simply starting your
interpretation of behaviour( e.g appear anxious).
MOOD AND AFFECT
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Describing mood
is a sustained emotion, subjectively experienced
and reported by an individual and observed by
others. Clients should be encouraged to describe
their emotional state in their own words.
mood is often described as depressed(sad), happy,
angry, anxious, apathetic,hypomanic.
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Describing affect
Affect is the observed expression of emotion. A
person’s affective state consist of several
components which are objectively observed. It
should be monited throught the interview. Written
descriptions of affect in the mental status
examination should be characterized in term of its
range, change pattern and intensity.
SPEECH AND LANGUAGE
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Describing the speech and Language
In this portion the interviewer evaluates and
documents the physical characteristics of the speech
and individuals use of language. Evaluation of the
speech and language can provide important clues
to an individual’s physical and mental state, thought
processes, cognitive organization and interlectual
capacity. Specific characteristics of speech which
should be described are Rate, Volume and Quality.
THOUGHT AND PERCEPTION
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In evaluation of thought and perception the
interviewer assess how well a person formulates,
organizes and express their thought as well as
abnormalities in thought contents or perception.
Evaluation of thought process
Evaluation of thought involves assesment of process(
the way aperson thinks) and contents( whats a
person thinks). The comprehensive evaluation of
thought process involves thought rate, thought flow
and thought form.
Abnormalities in thought process
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Its important to assess and document the presence
or absence of significant abnormalities in thought
process. This assesment is inferred from
communication or from direct questioning of the
client regarding what their thought are like. The
abnormalities includes
Tangentiality, circumstantiality, flight of ideas,
perseveration, neologism and thought blocking.
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Evaluation of perception
perceptual disturbances may be experienced in
reference to the self or enviroment. The perceptual
abnormalities includes
-Hallucinations
-Illusions
-Depersonalization
-Derealization
COGNITION
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Cognition is the ability to know and think using logic,
reasoning, memory and all high cortical functions.
In contract to other aspects of mental status exam,
cognition is tested in structed way. In cognition the
following will be assesed orientation, memory,
calculations, reading, writing capacity and language.
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Evaluation of orientation
orientation to person,place and time is a basic
cognitive function. Essentialy this mean that a person
knows who they are, where they are, and the date
or day of the week. A hospitilized person may not
know the exact date, but should remains clear on
month, season and year and be close to the day of
the week.
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Evaluating level of consciousness
the overall level of consciousness should be
documented. This is typically characterized as along
a continuum from alert to drowsy.
Evaluating attention and concentration
Attention is the ability to focus and direct cognitive
processes. Simple test of attention include asking the
person to name 5 things that starts with the same
letter.
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Evaluation of memory
memory impairement can be symtomatic of a
number of conditions including depression and
cognitive disorders. Its important to asses borth
short and long-term memory. The aspects of
memory which should be assessed are recall,recent
and remote.
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Evaluating reading and writing
this may be evaluated by asking the person to
read a sentence and then do what the sentence say.
For instance ‘close your eyes’. The person should
also be asked to write the short but complete
sentence.
INSIGHT AND JUDGEMENT
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Insight and judgement are complex cognitive task
which requires the utilization and intergration of
mental functions. The ability to make a sound
judgement require an adequate level of insight and
insight require critical ability to evaluate the
potential repercussions of one’s behaviour.
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Evaluate insight
Insight is the ability to be self aware. Involve the
capacity to examine many aspects and
consequences of issue before forming opinions or
making a decision. Sample question to elicit degree
of insight includes ‘what has brought you here
today’, ‘what do you think is a problem’.
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Evaluating judgement
judgement is a process of forming an opinion or
conclusion based on information about a situation
that can lead to a decision or action. Example of
questions in assesing the judgement includes. ‘what
would you do if you the train comes towards you on
the track?’
SUMMARY AND CONCLUSION
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To perform mental status examinatination, the
medical personel should combine the following
during assessment to give out the best treatment to
the patient, apperance, attitude, behaviour, mood,
affect, speech, language, thought,
perception,cognition, insight and judgement.
RECOMMENTATIONS
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Mental status examination is very important in
medical field since some patient do not show the
symtoms of mental illness unless are examined using
this test. By applying this test the mental illness will
be discovered and treated effectivelly.
REFFERANCE
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-Mental status assessment, American journal of
Nursing. August 1493-1517
-The psychiatry mental status examination, New
York 1993
-www.heaIthforum.com