Mental Status Exam Mnemonic
Editor's Note: The narration and closed captions in this video are in English. For subtitles in 13 other languages, see this video on the website of the .
Correspondence
N Engl J Med 1991; 324:636DOI: 10.1056/NEJM40918
To the Editor:
In trying to use the standard mental-status examination in their work with patients, medical students and nonpsychiatric physicians are often daunted by the fact that, as one recent author put it, "The Mental Status Examination is a profile of at least twenty psychic functions."
In the hope of improving psychiatric diagnostic capability by encouraging easier use of the examination, I suggest the mnemonic "como estas." Spanish-speaking practitioners will recognize it as a familiar salutation, meaning "How are you?" The letters in the mnemonic denote the following components of the examination:
C —cognitive functions, i.e., calculation, concentration, insight, and judgment;
O —overview, i.e., appearance, attitude, level of consciousness, and movements;
M —memory, i.e., recent and remote;
O —orientation, i.e., to person, place, and time;
E —emotion, i.e., affect and mood;
S —speech, i.e., fluency, form, and comprehension;
T —thought, i.e., process, content, and perceptual disturbances;
A —attention, i.e., abstract thinking, recall, and intelligence; and
S —something else that the practitioner has forgotten that might be important for the patient.
John Mann Astrachan, M.D.
903 Park Ave., New York, NY 10021
- Othmer E, Othmer SC. The clinical interview using DSM-III-R. Washington, D.C.: American Psychiatric Press, 1989.