The basis for the examination is formed by “observing” the patient during anamnesis and additional testing, and “exploring” the patient’s complaints and experiences. It is not only important to listen to “what” the patient says, but also observe “how” they describe and experience their symptoms. Based on this, it is possible to deduce if the complaint is presented reliably or if there are inconsistencies between verbal and non-verbal information presented.
Consider a patient who steps confidently into the office, without a backward glance or a forward peek into the office. Their handshake feels dry, not clammy, and there is no tremor in the hand. However, they inform you that they are very anxious and convinced someone is watching them.
You may detect inconsistencies between what the patient has told you and what you conclude from their non-verbal behaviour. It is important to consider the feelings/reactions a patient induces in you, and why. Such feelings/reactions may indicate inconsistencies between verbal and non-verbal behaviour or directly indicate the presence of psychopathology.
Mental status examination focuses on:
- Exploration.
- Observation.
- Self-observation.
