Mental Health Assessment: Screening for Anxiety, Depression, Personality and Psychotic Disorders; Patient History and Review of Systems Including Past Medical History, Family History, Social History, Trauma, Somatic Symptoms, Hormonal Disorders; Mental St

Mental Health Assessment: Screening for Anxiety, Depression, Personality and Psychotic Disorders; Patient History and Review of Systems Including Past Medical History, Family History, Social History, Trauma, Somatic Symptoms, Hormonal Disorders; Mental Status Exam Components Including Appearance and Behavior, Speech and Language, Thought Content and Perception, Insight and Judgement, Cognitive Functions, Orientation, Attention, Memory, Higher Cognitive Functions, Abnormal Speech Patterns (Circumstantiality, Flight of Ideas, Neologisms, Incoherence, Blocking, Confabulation, Preservation, Echolalia, Clanging), Thought Abnormalities (Compulsions, Obsessions, Phobias, Anxiety, Unreal Perceptions, Depersonalization, Delusions), Perception Abnormalities (Illusions, Hallucinations), Common Disorders (Depression, Mania, Bipolar Disorder, Schizophrenia, Anxiety, Delirium, Dementia), SIGECAPS Criteria for Depression Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 Mental health disorders Commonly masked by other health conditions Concerns with "difficult encounters" Poor adherence patterns May be associated with unresolved and unexplained somatic symptoms No longer viewed as strictly "binary" and exclusive of physical systems Screening for mental health disorders Unexplained symptoms lasting more than 6 weeks are correlated with depression/anxiety - should prompt screening, important patient understands that the clinician is not suggesting the symptoms is caused by psychological illness Screening should be 2-tier - brief with high sensitivity and specificity, then more detailed Personality and psychotic disorders Less commonly treated in primary care Require referral Assessment needs beyond screening for anxiety/depression More reliant on clinician observations of interactions the patient Mental health disorders: patient history and ROS Past medical history - pain, injuries, births Family history - some things run in families Social history - most significant, experienced some kind of trauma, referral for counseling ROS - help to rule out other causes of mental health disorders, think hormones (Grave's, hypothyroid, cortisol imbalance, etc) The mental status exam: Major components Appearance and behavior - general look, indicators like disinterest and lack of energy Speech and language - normal speed, very slowly, rate, volume, logical Mood - match what they are telling you how they feel, is there congruence, how fast do you become upset Thoughts and perceptions - ability to logic and receive reality, can they make sense of situations Cognitive functions - memory, ability to make decisions Appearance and behavior Largely derived from your interaction with the patient What does a depressed patient look like to you? an anxious patient? Look at the patient - is what you're seeing consistent with what you know about them Speech and language Quantity Rate Volume Articulation of words (angry) Fluency Abnormal speech findings Circumstantially Derailment Flight of ideas Neologisms Incoherence Blocking Confabulation Preservation - constantly circles back to a topic Echolalia - repeting Clanging - percussive like noises