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:

cognitive functions, i.e., calculation, concentration, insight, and judgment;

overview, i.e., appearance, attitude, level of consciousness, and movements;

memory, i.e., recent and remote;

orientation, i.e., to person, place, and time;

emotion, i.e., affect and mood;

speech, i.e., fluency, form, and comprehension;

thought, i.e., process, content, and perceptual disturbances;

attention, i.e., abstract thinking, recall, and intelligence; and

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

1. Othmer E, Othmer SC. The clinical interview using DSM-III-R. Washington, D.C.: American Psychiatric Press, 1989.