Mental status exam - Columbia University
Behavior Mood
Mental Status Examination I Definitions of Some Mental Status Examination Findings
psychomotor agitation - noticeable and marked increase in body movements; eg hand wringing, pacing psychomotor retardation - significant slowing of speech and body movements, lack of usual fidgetiness Expansive - enthusiastic
Euphoric - feeling great, as if one just won the lottery
Affect
blunted- decrease in amplitude of emotional expression
flat - virtually complete absence of affective expression
constricted - normal amplitude but restricted range
inappropriate - emotions expressed are .not congruent with content of patient's thoughts (occasion# nervous smiling or laughter is not sufficient)
labile - unpredictable shifts in emotional state
Thought process
circumstantial - organized but over inclusive, eventually gets to the point in a painstakingly slow manner
tangential - occasional lapses in organization such that the patient suddenly changes the subject and never returns to it; if a question is asked, it isn't answered
loosening of associations - frequent lapses in connection between thoughts
word salad - incomprehensible speech due to lapses in connections even within a single sentence; incoherent, a "tossed salad" of ideas
blocking - patient loses his or her train of thought; by definition, the patient should confirm the subjective experience of being blocked; the term should not be based on the interviewer's observation alone
neologisms - words that are created by the patient and have their own idiosyncratic meaning
flight of ideas - flow of thoughts is extremely rapid but connections remain intact
Thought content
Perception
delusion - a firmly held, false belief not shared by members of the patient's culture. By definition, reality testing is not intact (i.e., the patient is unable to consider the possibility that the belief is incorrect).
obsession - an idea that is intrusive and egodystonic; should not be confused with ruminations, which are egosyntonic, or delusions. By definition, reality testing is preserved (i.e., the patient will readily acknowledge that the obsession makes no sense.)
overvalued idea - a false belief not shared by members of the patient's culture that is not fixed (i.e. it is held to more firmly than one would expect but reality testing is maintained).
Paranoid ideation - (suspiciousness about others' motives) and ideas of reference (misinterpretation of external events as having particular meaning for the patient) are specific types of overvalued ideas.
Phobia - a specific fear that results in avoidance of the situation or object despite the patient's realization that the fear is irrational
illusion - misinterpretation of a sensory stimulus that can occur in any sensory rnodality (e.g., misperceiving billowing curtains in a darkened room to be an intruder)
hallucination - perceiving a sound, sight, taste, smell or touch in the absence of external sensory stimulation that seems indistinguishable from such an experience in reality
depersonalization - the sense that one is outside of his or her self
derealization - a vague sense of unreality in one's perception of the external world
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