Comprehensive Mental
Status Examination

A comprehensive mental status examination begins with a patient’s outer appearances and progressively proceeds into their interior life. A clinician must carefully observe and thoughtfully question a patient, all the while keeping in mind cultural context, developmental stage, and educational level. A clinician can organize their experience of a patient’s mental state using their own version of the format outlined below, which includes definitions for the essential terms for the mental status examination.


  • Ability to make and maintain eye contact
  • Appropriateness to situation
  • Attitude toward interview
  • Cleanliness
  • Dress
  • Grooming
  • Habitus (general constitution and physical build)
  • Posture


  • Ability to relate socially during your encounter
  • Ambulatory status and, if possible, gait
  • Catalepsy (maintenance of any physical position after being moved by examiner)
  • Posturing (striking a pose and maintaining it)
  • Drooling
  • Mannerisms (unnecessary behaviors that are part of goal-directed behaviors)
  • Presence of waxy flexibility (resistance of limbs to passive motion that improves with ongoing movement)
  • Psychomotor agitation (excessive physical activity accompanied by inner tension)
  • Psychomotor retardation (generalized slowing of cognitive, emotional, or physical responses)
  • Stereotypies (non-goal-directed behaviors that are unusual in frequency, but not in the action itself)
  • Signs of extrapyramidal symptoms or tardive dyskinesia
  • Tics (involuntary, recurrent, nonrhythmic movement or vocalization)
  • Tremor

Speech and Language

  • Amount
  • Latency (a pause of several seconds before responding to a question)
  • Rate
  • Rhythm
  • Tone
  • Volume
  • Anomia (inability to name everyday objects)
  • Dysnomia (inability to find words)


  • Affect (the emotional tone conveyed by speech and behaviors)
  • Alexithymia (inability to describe or recognize one’s own emotions)
  • Appropriateness to situation
  • Intensity
  • Mood (the emotional state which is sustained throughout the encounter
  • Quality
  • Range
  • Stability

Thought process

  • Mutism (absence of speech)
  • Alliteration
  • Aphonia (ability to only whisper or croak)
  • Thought blocking (sudden stops in the middle of a thought sequence)
  • Clang association (words chosen purely for sound)
  • Decreased latency of response (answering questions before you can finish asking them)
  • Increased latency of response (long pauses before fairly normal speech)
  • Derailment (running ideas into each other)
  • Distractibility (being easily diverted by extraneous stimuli)
  • Echolalia (repetition of words or statements of others)
  • Flight of ideas (an illogical group of associations)
  • Associations may be described as intact, circumstantial (providing unnecessary details but eventually answering a question), tangential (only initially responding to a question), or loose (providing responses unrelated to a question), or even word salad (random use of words)
  • Neologisms (creation of words)
  • Perseveration (repetition of the same motor or verbal response despite varied stimuli)
  • Poverty of speech (brief, concrete responses with limited spontaneous speech)
  • Push of speech (increased, rapid speech that is often loud and difficult to interrupt)
  • Verbigeration (prolonged repetition of isolated words)

Thought Content

  • Compulsions (irresistible impulses to perform a behavior)
  • Obsessions (recurrent, persistent idea, image, or desire that dominates thought)
  • Delusions (fixed, firm, false beliefs that are not part of a person’s culture or religion)
  • Grandiosity
  • Guilt
  • Hallucinations (perceptions of an absent stimulus
  • Illusions (misperceptions of an actual stimulus)
  • Ideas of persecution
  • Ideas of reference (perceptions that unrelated stimuli have a particular and unusual meaning specific to the person)
  • Ideation, intent, or plan to harm self or others (suicidal, homicidal, or violent)
  • Paranoia
  • Passivity (submissive attitude to a perceived superior
  • Phobias (intense, unreasonable, specific fears)
  • Thought insertion (perceiving that your thoughts are not your own, but inserted into your mind by others)
  • Thought withdrawal (perception that others can take thoughts out of your mind without consent)


  • Ability to abstract and to interpret culturally—and educationally— appropriate proverbs
  • Ability to calculate
  • Ability to read and write
  • Fund of general information
  • Learning style
  • Impulse control
  • Orientation
  • Recent and remote memory


  • Insight into their condition, especially as to whether they deny or appreciate their problem
  • Judgment (mental ability to compare choices and make appropriate decisions) as related to presenting condition and age