Medicine requires of its practitioners knowledge, expertise and skills to successfully diagnose and treat patients. The diagnostic process involves various forms of examination, each with its own systematic structure. First and foremost, a clear communication between physician and patient is required to initiate and successfully complete the diagnostic and treatment process lege artis (according to proven medical standards).

The mental functions of a patient form a crucial part in this diagnostic process. These mental functions determine:

  • how the patient understands his complaints;
  • how the patient expresses his complaints;
  • to what extent the patient feels incapacitated by his complaints;
  • what potential the patient feels to have to solve his problems.

For example, a patient suffering from a heart complaint is likely to communicate his complaints fearfully, while a patient suffering from a memory problem may have difficulty properly explaining the course of his complaint. A confused patient will not be able to explain his situation clearly, and a psychotic patient might offer an idiosyncratic explanation of his complaints, and may not be easily persuaded to cooperate in treatment. Moderately gifted patients may not have the words to explain their aches and pains, and those with a rigid mindset may not be open to possible alternative explanations of their complaints.

Mental functions are the basis of human functioning and interaction and determine form and content of personal beliefs, emotions and behaviour, or, in short: mental functioning. Therefore, physicians cannot ignore mental functioning of their patients. Mental functions affects the patient’s perception of his physical of mental complaints, and define how patients are able to agree with treatment suggestions. This means that all physicians need proper knowledge, skills and expertise in methodically observing and exploring psychopathological phenomena in the behaviour, feelings and experiences of their patients. In addition, each physician must have sufficient knowledge of the psychiatric diagnostic process to properly establish contact with a patient.

Please note that a dysfunction in one or more of these mental functions does not necessarily imply a psychiatric disorder in the person involved. Disturbances in mental functions lie in a continuum between ‘normality’ and ‘psychiatric disorder’, and are therefore not uncommon in the general population. In addition, disturbances in mental functions are commonly found in clinical syndromes of a purely somatic nature. When a physician observes mental dysfunctions in a patient, he should take into account the above mentioned considerations about the nature of psychiatric symptoms in the planning of future diagnostic consultation, examination and treatment

The goal of this program is to serve as a reference text for medical students but also for all physicians who want to deepen their knowledge of the mental state examination. It discusses the position of the mental status examination in the psychiatric interview and the key concepts of a mental status examination, and shows how the examination is properly conducted. The enclosed video-clips contains a number of interviews with patients. We recommend that you watch the entire interview first in order to understand the context of the film. Then, you can choose to look at the more detailed explication of the mental status examination of the patient. These guided film fragments include commentary on “what” kind of psychopathology is to be seen and heard, “how” that psychopathology will be labelled and “why” this clinical judgment has been given.