Test: Psychiatric screen

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Background/Purpose

The mental status examination includes general observations made during the clinical encounter, as well as specific testing based on the needs of the patient and physician. Multiple cognitive functions may be tested, including attention, executive functioning, gnosia, language, memory, orientation, praxis, prosody, thought content, thought processes, and visuospatial proficiency. Proprietary and open-source clinical examination tools are available, such as the Mini-Mental State Examination and the Mini-Cog. Physician judgment is necessary in selecting the most appropriate tool for an individual patient. These tools have varying sensitivity and specificity for neurologic and psychiatric disorders, but none are diagnostic for any mental status disorder. Each must be interpreted in the context of physician observation. The mental status examination is useful in helping differentiate between a variety of systemic conditions, as well as neurologic and psychiatric disorders ranging from delirium and dementia to bipolar disorder and schizophrenia. There are no guidelines to direct further testing in the setting of an abnormal mental status examination; therefore, testing is based on clinical judgment.

Procedure

The examination begins with a general assessment of the patient's level of consciousness, appearance, activity, and emotional state. Each of these items may be rapidly assessed by a physician in the initial moments of the encounter through history taking and general observation. These findings, combined with a brief memory test, may be all that is needed to ascertain that no pathology is present.

If the general assessment does reveal areas of concern, further in-depth investigation is warranted. When a more thorough examination is indicated, it may be separated into two general portions: observations made by the physician about the patient's physical state, and a cognitive evaluation in which the patient's neurologic and psychological functioning is assessed.
Performed: Bilaterally

Dialog

, and sleep disturbance. The patient is not nervous/anxious and is not hyperactive

Criteria

• Negative for agitation, behavioral problems
• Negative for confusion, dysphoric mood
• Negative for sleep disturbance
• Negative for nervous/anxious and is not hyperactive

Measurement

LOINC Code

Scale/Grading

selection range; grade - LOINC ID
Option - Value option selection range; grade - LOINC IDPass ; Pass - Fail ; Fail -