What are 4 things that the mental status test evaluate?

Apraxia: difficulty performing targeted, voluntary movements despite an intact motor function and the willingness to perform the movement

It is typically assessed by evaluating the patient's response to external stimuli and can be described using the following:
- Somnolence
  - drowsiness from which a patient can be easily aroused
  - The patient responds normally except for a slight delay when addressed
- Stupor
  - A state of insensitivity bordering on unconsciousness; patient is not easily awoken, except if exposed to strong external stimuli,; into which the patient returns in the absence of further stimulation
  - painful stimulus provokes a withdrawal response
- Coma
  - unarousable unresponsiveness regardless of the stimulus, typically lasting for 2–4 weeks
- Delirium
Glasgow Coma Scale (GCS): A common neurological scoring scale used for the evaluation of consciousness in acute settings (especially after head injury) and sometimes for monitoring patients in the ICU.
- Patient's verbal, motor, and eye-opening responses are scored on a scale of 1–6 points; 1 point denotes a complete lack of response and 6 points denotes normal findings.
- See “Diagnostics” in traumatic brain injury for more information.

Memory (cognition)
- Amnesia: loss of memory
  - Retrograde amnesia: inability to recall memories and/or information acquired prior to the incident
  - Anterograde amnesia: inability to recall memories and/or information acquired after the incident
  - Global amnesia: inability to recall memories and/or information acquired prior to and after the incident
Calculation
- perform simple calculations

Some of the speech abnormalities that can be observed during an MSE include:
- Word salad: incoherent thinking expressed as a sequence of words without a logical connection
  - Characteristic of schizophrenia and dementia

Thought processes
	Description	Characteristic of	Example
Circumstantial thought process	Nonlinear thought expressed as long-winded explanations and with multiple deviations from the central topic before a central idea is finally expressed		When a patient is asked where they are from, they describe their favorite hometown diners before answering your question.
Tangential thought process	Nonlinear thought expressed as a gradual deviation from a focused idea or question. The patient provides multiple, unnecessary details related to the question without actually answering the question.	Schizophrenia Anxiety Delirium [8]	When asked about their medical history, the patient describes the hospitals they have stayed in without mentioning their medical conditions.
Loose associations/derailments	Incoherent thinking expressed as illogical, sudden, and frequent changes of topic	Schizophrenia Other psychotic disorders [9]	When asked about their job, the patient remembers some funny stories from their childhood and then starts talking about the weather.
Flight of ideas	The quick succession of thoughts usually expressed as a continuous flow of rapid speech and abrupt changes in topic	Bipolar disorder (manic phase)	When asked how they are feeling, the patient delivers a 10-minute monologue on different topics using rapid, intangible speech.
Clang associations	The use of words based on rhyme patterns rather than meaning	Schizophrenia Manic states [10]	When asked “Have you ever smoked?” the patient responds with “Never have I ever, never never ever.”
Perseveration	The inappropriate repetition or persistence of behavior, speech, or sounds		When asked three different questions, the patient gives the same answer each time.
Thought blocking	The abrupt ending of a thought process expressed as a sudden interruption in speech	Schizophrenia Other psychoses [12]	The patient stops in the middle of answering a question

Delusions are fixed, false beliefs (unrelated to one's religious beliefs or culture) that are maintained despite being contradicted by reality or rational arguments.

Delusions according to their content
Type	Description	Assess by asking patient if they:
Persecutory delusions	The patient insists that they are being cheated on, conspired against, or harassed.	Feel wronged or threatened by a person or group of individuals
Paranoia	The patient has an exaggerated distrust of others and is suspicious of their motives.	Sometimes have the feeling that a person or group of individuals wants to harm them
Grandiosity	The patient insists that they have special powers or importance (e.g., a patient saying they can read minds).	Feel like they are destined for something special or have special abilities
Erotomania	The patient believes that other individuals are in love with them (e.g., a patient claiming a famous actress is sending them love letters).	Have a special someone who is in love with them and sending secret messages
Jealousy	The patient believes their partner is unfaithful without justification.	Have the feeling that their partner is unfaithful to them
Delusion of reference	The patient believes that normal events are of special importance to them (e.g., an individual might feel that a television reporter is talking about them).	Have the feeling that people on the street, on the radio, or on TV are talking about them and trying to send them messages
Somatic delusions	The patient believes there is something abnormal about their body function or appearance (e.g., an individual might feel like they are missing a hand).	Think that there is something wrong with a part of their body
Religious delusions	The patient believes they have divine powers, receive messages from God, or that they actually are God.	Have been in contact with a religious figure or have a spiritual mission of some sort
Delusion of poverty	The patient believes they are financially incapacitated or that poverty is inevitable.	The feeling that they are in some financial trouble
Delusion of guilt	The patient believes that they have wronged someone and/or are responsible for something bad.	The feeling that they harmed someone or have done something bad
Mixed delusions	The simultaneous occurrence of two or more delusions; neither delusion is predominant
Unspecified delusion	A type of delusion that does not fit the criteria of other types or that cannot be clearly defined

To remember the different types of delusions (Grandiosity, Erotomanic, Ideas of reference, Paranoid, Persecutory, Somatic, Jealousy), think: “Grand, Erotic Ideas can cause Paranoia, Persecution and So much (so-ma-tic) Jealousy.”

Suicidal and homicidal ideation

Assessment
- Can range from a brief consideration of the act to concrete planning of the time, place, and/or method of suicide/homicide.
  - Assess the threat (organized plan, access to weapons).
  - Admit the patient involuntarily if they refuse medical care.
  - In homicidal threats, inform the authorities and the threatened individual.

Hallucinationsa type of perceptual abnormality in which sensory experiences occur in the absence of external stimuli.

Perceptual disturbancescharacterized by inaccurate perception (distortion) of real sensory input (e.g., perceiving a stationary object as being in motion)

Hemineglectimpaired ability to perceive and respond to different types of stimuli coming from one side of the body usually due to a brain unilateral injury (most commonly strokes).
Typically associated with right hemisphere damage resulting in neglect (esp. visual) of the left side
Common types:
- Motor neglect
- Sensory or perceptual neglect

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