Evaluation of behavioral and cognitive changes: the mental status examination

Patients who present to the Emergency Department with a behavioral or cognitive disorder should be treated in an organized fashion. The most important element of their care is determining the etiology of their abnormality, whether organic or functional. The history and physical examination, along with laboratory and ancillary testing, should be directed toward this objective. The mental status examination plays a critical role in establishing the diagnosis. It must be focused and brief. By focusing on seven major areas (affect, attention, language, orientation, memory, visual-spatial ability, and conceptualization), a quick and thorough examination of the patient's mental status can be performed.