Component	Elements to assess	Potential illnesses	Sample questions
Appearance and general behavior	Body habitus, grooming habits, interpersonal style, degree of eye contact, how the patient looks compared with his or her age	Disheveled appearance may suggest schizophrenia	—
		Provocative dress may suggest bipolar disorder
	Appearance: well-groomed, immaculate, attention to detail, unkempt, distinguishing features (e.g., scars, tattoos), ill- or well-appearing	Unkempt appearance may suggest depression, psychosis
	Eye contact: good, fleeting, sporadic, avoided, none	Poor eye contact may occur with psychotic disorders
	General behavior: congenial, cooperative, open, candid, engaging, relaxed, withdrawn, guarded, hostile, irritable, resistant, shy, defensive	Paranoid, psychotic patients may be guarded
		Irritability may occur in patients with anxiety
Motor activity	Body posture and movement, facial expressions	Parkinsonism, schizophrenia, severe major depressive disorder, posttraumatic stress disorder, anxiety, medication effect (e.g., depression), drug overdose or withdrawal, anxiety	—
	Akathisia (restlessness), psychomotor agitation: excessive motor activity may include pacing, wringing of hands, inability to sit still
	Bradykinesia, psychomotor retardation: generalized slowing of physical and emotional reactions
		Symptoms may develop within weeks of starting or increasing dosages of antipsychotic agents
	Catatonia: neurologic condition leading to psychomotor retardation; immobility with muscular rigidity or inflexibility; may present in excited forms, including excessive motor activity
		Tendency toward exaggerated movements occurs in the manic phase of bipolar disorder and with anxiety
Speech	Quantity: talkative, expansive, paucity, poverty (alogia)	Schizophrenia; substance abuse; depression; bipolar disorder; anxiety; medical conditions affecting speech, such as cerebrovascular accident, Bell palsy, poorly fitting dentures, laryngeal disorders, multiple sclerosis, amyotrophic lateral sclerosis	—
	Rate: fast, pressured, slow, normal
	Volume and tone: loud, soft, monotone, weak, strong, mumbled
	Fluency and rhythm: slurred, clear, hesitant, aphasic
	Coherent/incoherent
Mood and affect	Affect: physician's objective observation of patient's expressed emotional state Mood: patient's subjective report of emotional state	Depression, bipolar disorder, anxiety, schizophrenia	How are your spirits?
			How would you describe your mood?
			Have you felt discouraged/low/blue lately?
			Have you felt angry/irritable/on edge lately?
			Have you felt energized/high/out of control lately?
Thought process	Form of thinking, flow of thought	Anxiety, depression, schizophrenia, dementia, delirium, substance abuse	—
Thought content	What the patient is thinking about	Obsessions, phobias, delusions (e.g., schizophrenia, alcohol or drug intoxication), suicidal or homicidal thoughts	Obsessions: Do you have intrusive thoughts or images that you can't get out of your head?
			Phobias: Do you have an irrational or excessive fear of something?
			Delusions: Do you think people are stealing from you? Are people talking behind your back? Do you think you have special powers? Do you feel guilty, as if you committed a crime? Do you feel like you are a bad person? (Positive responses to last two questions may also suggest a psychotic depression)
			Suicidality: Do you ever feel that life is not worth living? Have you ever thought about cutting yourself? Have you ever thought about killing yourself? If so, how would you do it?
			Homicidality: Have you ever thought about killing others or getting even with those who have wronged you?
Perceptual disturbances	Hallucinations	Schizophrenia, severe unipolar depression, bipolar disorder, dementia, delirium, acute intoxication and withdrawal	Do you see things that upset you? Do you ever see/feel/hear/smell/taste things that are not really there? If so, when does it occur? Have you had any strange sensations in your body that others do not seem to have?
Sensorium and cognition	Sensorium: level and stability of consciousness	Underlying medical conditions, dementia, delirium	See Tables 2 and 3
	Cognition: attention, concentration, memory
Insight	Patient's awareness and understanding of illness and need for treatment	Bipolar disorder, schizophrenia, dementia, depression	What brings you here today? What is your understanding of your problems? Do you think your thoughts and moods are abnormal?
Judgment	Patient's recognition of consequences of actions	Bipolar disorder, schizophrenia, dementia	What would you do if you found a stamped envelope on the sidewalk?
			Physician should adapt questions to clinical circumstances and patient's education level