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Mental Status Examination

Posted by Margaret Donohue on July 28, 2017 at 10:00 PM

The Mental Status Examination

The mental status examination is a screening test for a wide variety of mental disorders and conditions. In it’s most common form it is abbreviated to a mini state exam with fewer categories and often used to evaluate cognitive difficulties.

The full exam consists of evaluation in multiple categories:

  • Appearance and behavior
  • Orientation, concentration and attention
  • Language and memory
  • General information and intellect
  • Thought process
  • Thought content
  • Mood and affect
  • Delusions, illusions and hallucinations
  • Insight and judgment
  • Abstract reasoning and synthesis of thought
  • Reading, writing and math
  • Drawing and copying
  • Repetition, Registration
  • Risk assessment
  • Validity of assessment results and effort of person being evaluated


The mini exam has fewer categories and is generally used to assess significant cognitive impairment:

  • Orientation
  • Immediate Recall
  • Counting backwards
  • Spelling backwards
  • Delayed Recall
  • Language Naming
  • Repetition of a complex phrase
  • Following a three step-command
  • Reading
  • Writing
  • Copying


A standard verbally based IQ test combined with behavioral observations will provide as much or more information than a full mental status examination if performed by a skilled examiner. If the examiner is familiar with a wide variety of psychological and neuropsychological test instruments the screening test can be scaled up to reflect a higher general education or premorbid level of intellect or scaled down to reflect someone from a more culturally improverished environment. Items can be substituted to document more subtle degrees of impairment and to clarify areas of strengths as well as areas of weakness or concern.

A skilled examiner performing the examination in it’s complete form can be as much art as science. Some parts of the test are developmental in nature, so some items are easier to complete than others for average people with no impairment. Most people with no difficulties will pass a mental status examination with very few minor errors. Significant cognitive impairment is readily apparent to a trained observer on presentation and a mental status examination is simply for the purpose of documenting global difficulties. Likewise, individuals attempting to fabricate results often perform so poorly as to be obvious.

If you know of someone needing an assessment, feel free to contact our office. We offer a wide variety of assessment and treatment services.

Categories: General Psychology, Diagnosis

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