Comprehensive Mental Status Examination and Significance to the Advanced Practice Nurse

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Introduction to the Comprehensive Mental Status Examination
A comprehensive mental status examination is an essential diagnostic tool for psychiatric and neurological cases. This examination assesses a patient’s behavior and mental state. A clinician conducts the mental status examination by interviewing the patient, asking questions, and observing the patient’s response and behavior, both qualitatively and quantitatively. This helps form a basis for treatment decisions while also providing vital information to establish a diagnosis as per the DSM-5 criteria (Norris et al., 2016).
There are various considerations when conducting the mental status examination, and these include cultural background, religious affiliation and beliefs, level of education, and social background. These are relevant when conducting and interpreting the examination because these influence differences in behavioral patterns that each patient may demonstrate. These factors are also applicable to the clinician conducting the examination because they also alter his comprehension of the patient’s verbal and non-verbal communication (Lewis, 2016). This paper will discuss the parts of a comprehensive mental status examination and its significance to nursing practice.
Parts of a Comprehensive Mental Status Examination
The comprehensive mental status examination consists of numerous parts, and the main components are the following: Appearance and behavior; sensorium and cognition; mood and affect; speech; thought process; thought content; perceptual disturbances; and insight and judgment (Norris et al., 2016).
The patient’s appearance provides insight into the patient’s ability to perform self-care and his overall lifestyle. Some of the main things noted are the patient’s weight, estimated age versus how the patient looks, hygiene, and distinguishing features such as tattoos, manner of dressing, etc. This is also associated with many psychiatric conditions. For example, a severely depressed patient will demonstrate significant weight loss, while a person in a manic episode may present himself with bright and colorful hair. Similarly, eye contact, distress level, and attitude during the interview are also important during the assessment. An example would be frequent glances shared with patients experiencing visual or auditory hallucinations associated with schizophrenia (Schmidt & Martin, 2019).
The patient’s sensorium and cognition involve the assessment of his orientation to person, place, and time, level of consciousness, executive functions, reasoning, language, concentration, attention span, and memory. These are significant in many conditions such as head trauma, substance abuse, hypoglycemia, acute kidney injury, etc. Therefore, during the interview, screening tools for specific cognitive functions are also utilized. Alterations in these can indicate a particular condition, and an example could be acalculia indicating parietal lobe lesions or decreased level of knowledge indicating possible dementia (Norris et al., 2016; Lim et al., 2018).
The patient’s mood is assessed, focusing on the subjective input of the patient about how they feel and are recorded in their own words. On the other hand, the effect is the clinician’s objective evaluation of the verbal and non-verbal communication conveyed by the patient during the interview (Voss & Das, 2021). The appropriateness and congruency between the two are also assessed. An example would be an exaggerated euphoric effect on a patient experiencing mania while fixed and constricted effects for patients suffering from severe depression (Norris et al., 2016).
Speech assessment is the evaluation of the act of speaking, and impairments related to this may indicate various conditions. The assessed components of speech are its volume, rate, articulation and fluency, quantity, and latency. For example, a case of soft, incomprehensible speech can already indicate depression, especial...