1. MENTAL STATUS EXAMINATION
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2. Mental status examination
• Consciousness
• Rapport
• General appearance and motor behavior
• Attention and concentration
• Language functions
• Orientation
• Memory
• Abstract ability
• Judgment
• General information
• Calculation
• Intelligence
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3. Mental status examination
• Thought
o Stream
o Form
o Possession
o Content
• Mood and Affect
• Perception
• Other psychotic phenomena
• Insight
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4. Thought Stream- (Progress)
o Spontaneity
o Volume
o Tonal fluctuations
o Retardation
o Pressured speech
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5. • Poverty of speech: Restriction in amount, brief,
concrete, unelaborate
• Poverty of content: Long reply, adequate speech, less
content
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6. • Flight of Ideas:
• Thoughts follow each other rapidly
• No general direction of thinking
• Connections between successive thoughts
appear to be due to chance and can usually be
understood (alliteration, clang)
• E.g.: I live in Birmingham, Kingstanding, see
the king, sing sing, bird on the wing….
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7. • Prolixity: Ordered flight of ideas
• Speed not as fast
• Despite irrelevances, able to return to the task
• Circumstantiality:
• Unnecessary and trivial details, but finally the
point is reached
• Goal is never completely lost
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8. • Inhibition or retardation:
• Train of thought is slowed down
• Number of ideas, images decrease
• Usually experienced as difficulty in making
decisions, lack of concentration or loss of
clarity of thinking
• Depression
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9. Mood and affect
• Mood-
Prolonged subjective prevailing state or disposition;
• Sad, happy, worried, angry, fearful;
• Depth; predominant mood over the last 1 week
• Affect-
Objective state; range, reactivity, mobility and
communicability;
• Depressed, elated, euphoric, anxious, perplexed, blu
nted 9

10. Other psychotic phenomena
• Somatic passivity- bodily sensations especially
sensory symptoms experienced as imposed by
external force
• Made action, affect and impulse
• Negative symptoms
• Depersonalization and derealization
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11. Insight
• Awareness,
• Attribution and
• Acceptance of intervention
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12. 6 grades
o Grade 1: Denial
o Grade 2: Slight awareness but denying it at the
same time
o Grade 3: Awareness present but attribute it to
external factors
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13. o Grade 4: Awareness present but attribute it to
something unknown, acceptance
o Grade 5: Intellectual insight- Awareness present,
attributes it to psychological causes but does not
apply it to future experiences
o Grade 6: True emotional insight
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14. Case summary
• Basic data and socio-economic profile
• Presenting complaints (including HOPI)
• Relevant past, family, developmental,
occupational history etc.
• Pre-morbid personality
• Relevant M.S.E. findings
• Relevant Physical examination findings
• Diagnosis
• Management
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