Mental Status Exams Questions to Expect Check FAQs Update

Filed in Education by TMLT Editorials on March 11, 2021

Mental status exams questions are the psychiatrist’s version of the physical examination. In 1918, Adolf Meyer developed an outline for a standardized method to evaluate a patient’s “mental status” for psychiatric practice. It combines information gathered from passive observation during the interview with data acquired through direct questioning to determine the patient’s mental status at that moment.

What Is Mental Status Examination?

The Mental Status Exam is analogous to the physical exam: it is a series of observations and examinations at one point in time. Focused questions and observations can reveal “normal” or pathological findings.

The Mental Status Examination (MSE) is a standardized procedure used to evaluate the client’s mental and emotional functioning at the time the client is seen by the mental health professional. It involves a precise series of observations as well as some specific questions.

Each of the topics listed below is included in the MSE because it provides valuable information about the client’s function. A completed MSE analysis is usually only a short paragraph of condensed information, yet it contributes greatly to the diagnostic picture.

The items included in the MSE are:

Appearance, behavior, and attitude
Characteristics of speech
Affect and mood
Thought content, thought-form, and concentration
Orientation
Memory
General intellectual level
Insight and judgment

Mental Status Exams Questions to Ask About Mood

How do you generally feel most of the time?
What’s your mood like?
How would you say you feel generally – happy, sad, frightened, angry?

Questions to ask about low or high mood

Do you feel miserable all the time?
Do you ever cheer up, even a little bit?
Do you ever enjoy anything?
If something nice happens, do you cheer up a bit?
Do you cry?
Would you say that you’re more cheerful than usual?

Mental Status Exams Questions About Suicidal Intent

Do you ever feel really desperate?
Do you ever feel life is not worth living?
Do you ever feel it would be better if you were dead?
Do you ever feel that it wouldn’t matter if you didn’t wake up in the morning?
Do you ever wish you were dead?
Have you thought seriously about killing yourself?
Have you thought about how you might kill yourself?
Have you done anything about getting ready to kill yourself? (E.g. paying bills, hoarding tablets.)
Do you think that you might actually kill yourself?
Do you really want to die?
Would you say that you were determined to kill yourself?

Questions about biological features of affective disorder

Is there any pattern to how your mood changes through the day?
Is there any time of day when you tend to feel better or worse?
Do you tend to feel worse in the evening?
What’s your appetite like?
How are you eating?
Is there any change in your weight?
How are you sleeping?
What time do you get to sleep and what time do you wake?
Do you sleep right through or wake in the night?
After you’ve woken do you get back to sleep?
What time do you eventually wake in the morning?
Is there any change in your interest in sex?
Are you less interested in sex than usual?
Is there any change in how often you defecate/have your bowels open?
Do you experience constipation?
Is there any change in your energy levels?
Do you have more or less energy than usual?

Mental Status Exams Questions About Thought Form

Do your thoughts seem faster than normal?
Do you find you have lots and lots of different thoughts?
Does your mind seem to be slowed down?
Do you ever have the experience when your thoughts suddenly stop?
Do you ever feel that your mind is suddenly wiped blank and you have no thoughts at all?

Questions about passivity

Do you ever feel that somebody else controls your body?
Do you ever have something else moving your arms or legs?
Can anybody else move your body without you being able to stop them?
Do you ever find that a spirit/djinn/demon controls your body?
Has anything inside your body or brain been changed?
Is there anything strange inside your body?

Mental Status Exams Questions About Depressive Cognitions

What’s your opinion of yourself?
Do you think you’re better than most people, worse, or about the same?
Are you a good or bad person?
Are there things you feel guilty about?
Do you feel more guilty about things than most people?
Do you feel guilty about things that other people wouldn’t feel guilty about?
What’s your view of the future?
Do you think things will get better or worse?
Do you hope things might get better?
Is there any possibility that things might get better?
Do you see any possibility at all that things might get better, even a little bit?

Questions about delusions

Do you ever feel that people are following you?
Do you ever feel that people are seeking to harm you in some way?
Do people spy on you?
Has anything strange or unusual been going on?
Is there anything special about yourself that makes you different from other people?
Is there anything you can do which other people can’t?
Is there anything that particularly bothers you?
How did you find out this was happening?
When did you realize this?
How do you know about this?
Are you sure this is happening or might you be imagining it?
Are you absolutely certain this is what’s going on?
Do you think that somebody has put a spell on you?
Is a spirit/djinn/demon causing problems for you?

Questions about thought withdrawal

Does anything ever take your thoughts away?
Do you ever have your mind wiped blank?
Does anything take thoughts out of your mind so that they’re not there anymore?

Questions about compulsions

How often do you wash?
Do you wash your hands a lot?
Do you always do it in a particular way?
Do you feel that you have to do it?
Do you try to resist but find that you can’t?
What would happen if you didn’t do it?
Do you have to check you’ve locked the door properly?
Do you check locks, windows, switches, electrical appliances?
How many times would you check?
Do you do the checking in a particular order?
How much time does it take you?

Mental Status Exams Questions about Perceptual Abnormalities

Do you hear voices?
Do you see visions?
Do you hear people talking when there’s nobody there?
Do you hear things other people don’t hear?
Do you ever hear anything strange?
Where do the voices come from?
Are the voices in your head or outside?
Are these thoughts in your mind or sounds that you would hear with your ears?
How many voices are there?
Do they talk to you or do they talk to each other about you?
Do they ever talk about what you are doing?
Do they repeat your thoughts or comment on your thoughts?
Do your thoughts ever sound loud, as if somebody next to you could hear them?
Do the voices tell you to do things?
Do you ever hear angels talking?
Do you ever hear spirits/djinns/demons talking?
Do you see strange things?
Do you see things other people don’t see?
Do things ever smell strange or taste strange?
Do you feel things touching you?
Do you feel things changing inside your body?

Many aspects of the MSE are extremely subjective. There is tremendous potential for our own cultural exposure and background to color these assessments. Realize that there is a major distinction between “different” and “abnormal.” Proverbs, for example, are not necessarily a part of any communal experience. Thus, a “failure” to provide a correct interpretation may in fact have nothing to do with an individual’s intellectual function but rather may simply reflect a different upbringing or background.

Quantifying and defining the nature of a specific abnormality is an important part of the practice of medicine. While it is reasonable to expect that people be aware of certain basic facts (e.g. their name, the year, the purpose of their visit to the hospital, etc.) it is also important to recognize that our observation and interpretation of patient behavior and responses are colored by our own life experiences.

CSN Team.

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