Mental Status Exam - What is this? Is it something to be afraid of?

When you go to see a doctor, they will examine your body, talk to you, and sometimes ask you some questions to check your 'mind', right? More precisely, your mental state. Some people may find this a little strange. "Why are you asking me these questions? Do you think I'm crazy?" You may be wondering. That's what we call a 'Mental Status Exam'. Don't worry, this isn't as serious as you think, it's actually very common. Let's see what this really means and why it's important.

What is this Mental Status Exam?

Simply put, it's a way of examining your mind and brain, much like a doctor would do a physical examination. It's about getting a rough idea of ​​how you learn and understand the world around you. Although it's often used by psychiatrists, any doctor can perform this test.

During this examination, the doctor will mainly focus on the following things about you:

• Your general appearance and cleanliness
• Your behavior and body movements
• How you see and understand the world around you (Perceptions)
• How you express your mood and emotions (Mood and affect)
• Your cognitive abilities (Cognition). That means things like attention, memory, reasoning ability, and decision-making ability.

This test is very helpful in diagnosing mental health conditions (such as schizophrenia or anxiety ) as well as diseases related to the nervous system (such as Alzheimer's disease or Parkinson's disease) , and in monitoring whether those conditions change over time.

In what cases is this test performed?

Usually, any time you see a doctor, or during follow-up appointments, your doctor can perform parts of this test. The information they get will help them decide if you need any further tests and what type of treatment is best for you.

Also, there are several other factors that can affect the results of this test. The doctor will take all of these into account.

• Your culture: Some cultures express emotions differently.
• Your native language: It may be difficult to answer due to a language issue.
• Your level of education: Your level of education may affect the answers to some questions.
• Other external factors: Things like lack of sleep, hunger, and pain can impair your attention and memory.

Therefore, a doctor will never conclude that you have a disease based on this test alone. He or she will do so by combining a lot of other information from you. This includes:

• Details about your current medical condition.
• Your history of previous mental illnesses.
• Details about your other illnesses (past medical history).
• Details about drug or alcohol use.
• Your social and family background.
• General physical examination.
• Neurological exam.
• Test reports such as blood tests.

So, what exactly does the doctor look for in this test?

This examination can be divided into two parts. One is the information the doctor will obtain by observing you. The other is the information he will obtain by asking you questions.

Things they observe

The doctor will be observing you from the moment you enter the room. Don't think of this as a detective's job, this is to get a clear picture of your condition.

Questions they ask and things they check

In addition to observation, the doctor will ask direct questions to learn more about your mental functioning.

• Mood: Trying to gauge your mood by asking a simple question like "How are you feeling?"
• What you're thinking: Asks about what's on your mind, especially thoughts of harming yourself (thoughts of suicide) , thoughts of harming others, and delusions that you hold strongly even though they contradict your beliefs .
• Perception: Asks about what you perceive through your five senses (eyes, ears, nose, tongue, skin). This mainly looks at whether you hear or see things that aren't there (hallucinations) .
• Insight: This measures how much understanding you have about yourself, your behavior, and how you function in society.
• Judgment: This will test your ability to make good decisions. For example, you might be asked a question like, "What would you do if you saw an envelope with an address on it while you were walking down the street?" This will also be influenced by your past behavior, such as whether you take your medication as prescribed.

Specifically, your cognitive abilities (Cognition) are tested.

This is a very important part of the test. It helps you get a clear idea of ​​how your brain is functioning.

• Alertness: How conscious you are. For example, whether you are fully awake and responsive, or in a stupor or coma.
• Orientation: This is the part where you've probably heard the "Who? Where? When?" questions. The doctor will ask you your name, location (hospital, city), and date.
• Attention and concentration: This tests how long you can focus on one thing. For example, you might be asked to subtract 7 from 100. Or you might be asked to clap your hands when you hear the letter 'A' when you hear a few letters.
• Memory: Tests various parts of memory.
• Immediate recall: Three words are said and asked to be repeated immediately.
• Recent memory: After a few minutes, the three words you said earlier are heard again.
• Long-term memory: Asks you about old details, like where you were born and where you went to school.
• Abstract reasoning: This tests your ability to understand hidden meanings and concepts. For example, you might ask, "What is the difference between an apple and an orange?" Or you might ask, "What is the meaning of the metaphor, 'Ginger is like chili pepper.'"

If the results are abnormal, what happens next?

If the doctor finds something abnormal during the examination, he or she will not immediately say that you have a disease. First, he or she will ask you more questions. For example, if you are having difficulty concentrating, he or she may ask, "How many days have you not slept well?" This could be due to something as simple as lack of sleep.

Then, you may be ordered to do some tests to find out if there is a physical cause for your symptoms.

In some cases, more complex tests may be required.

• Brain imaging tests such as PET scan or brain MRI .
• EEG (Electroencephalogram) test (which measures the electrical activity of the brain).
• Examination of the spinal fluid (cerebrospinal fluid).

After all of this, your doctor will explain the results of the tests to you and decide with you what to do next.