MENTALSTATUSEXAMINATION：精神状态检查.pptVIP

MENTAL STATUS EXAMINATION Outline Operational definition Purposes Components Behavior Cognition Emotion Cognitive examination Mini Mental Status MENTAL STATUS EXAMINATION: What is it? ASSESSMENT of the: Behavior (see it all) Emotion (see some of it) Cognition (see none of it) Exhibited by the patient during the entire medical encounter PURPOSES ? Detect ? Describe ? Neuroanatomical localization ? Assess functional implications of Abnormalities/deficits in: ? Behavior ? Emotion ? Cognition ABNORMALITIES DEFICITS Require diagnostic explanation May compromise capacity to coherently and reliably describe medical state to give informed consent to adhere to a therapeutic plan MEDICAL ENCOUNTER Comprehensive global assessment BEHAVIOR Appearance Attitude Activity Speech Dress Grooming Hygiene BEHAVIOR Appearance Attitude Activity Speech Dress Grooming Hygiene COGNITION Thought content Thought progression Insight/judgment BEHAVIOR Appearance Attitude Activity Speech Dress Grooming Hygiene COGNITION Thought content Coherence Goal directedness Insight/judgment Operations Arousal Attention Memory Emotion Language Reasoning BEHAVIOR Appearance Attitude Activity Speech Dress Grooming Hygiene EMOTION Affect Mood Suicide Homicide COGNITION Thought content Coherence Goal directedness Insight/judgment Operations Arousal Attention Memory Emotion Language Reasoning BEHAVIOR Appearance appears stated age, uses a cane to walk Attitude cooperative, hostile, detached Activity normal, increased, agitated, subdued Speech normal rate/rhythm, dysarthric Dress casual, provocative, dirty Grooming disheveled, meticulous Hygiene clean, malodorous COGNITIVE EXAM (揗ental status? REASONING LANGUAGE MEMORY ATTENTION AROUSAL COGNITIVE EXAM (揗ental status? REASONING LANGUAGE MEMORY ATTENTION AROUSAL Must know education Can the patient hear? MEMORY Immediate memory = attention Recent memory (episodic) Recall of three words at 5 minutes Ensure that