MOTHER:I’m at home at 308 Park Place. I wish
John would come home. I feel better
when he’s here. I just can’t handle it.
Nobody thought I should get
married.VOLUNTEER: What do you think is wrong? Are you
afraid of hurting Danny?
MOTHER: He won’t stop crying. He’s
always crying. John doesn’t know
what it’s like. I suppose he blames
me—I know my mother does.
(Starts crying uncontrollably.)
VOLUNTEER: Look, that’s all right. Take it easy.
Where is John?
MOTHER:He’s...he drives a truck. He won’t
be back till Thursday.
VOLUNTEER: I think I understand...and I know
this is hard for you. Have you talked
with anybody about your feelings on
these things?
MOTHER: No. Well, with Marge next door a
little bit. She said she felt like that a
few times. But...I don’t know.T A B L E 6-3 Mental Status Examination Interview of a 24-Year-Old Man Diagnosed
with Schizophrenia
General Outline of Mental Status Examination
I. General Presentation: Appearance, Behavior, Attitude
II. State of Consciousness: Alert, Hyperalert, Lethargic
III. Attention and Concentration
IV. Speech: Clarity, Goal-directedness, Language deficits
V. Orientation: To Person, Place, Time
VI. Mood and Affect
VII. Form of Thought; Formal Thought Disorder
VIII. Thought Content: Preoccupations, Obsessions, Delusions
IX. Ability to Think Abstractly
X. Perceptions: Hallucinations
XI. Memory: Immediate, Recent, Remote
XII. Intellectual Functioning
XIII. Insight and Judgment
The patient appeared disheveled and exhibited“odd”behavior throughout the interview. Although he appeared alert,
some impairment in his attention and concentration was noted. Specifically, he experienced difficulty repeating a series
of digits and performing simple calculations without the aid of pencil and paper. No language deficits were noted,
although the patient’s speech was at times difficult to understand and did not appear to be goal-directed (not a
response to the question posed). He was oriented to person and place, but was not oriented to time. Specifically, he was
unsure of the month and day. He reported his mood as“fine”; his affect appeared to be blunted. He demonstrated
some signs of formal thought disorder: tangentiality and loose associations. He denied suicidal ideation but did report
his belief that he was being“framed by the FBI”for a crime he did not commit. When confronted with the fact that he
was in a psychiatric hospital, not a prison, he stated that this was all part of an FBI“cover-up,”so that he could be made
to look“crazy.”Although he denied hallucinations, his behavior suggested that, on occasion, he was responding to
auditory hallucinations. For example, he stared off into space and began whispering on several occasions. His ability to
abstract appeared to be impaired. For example, when asked how a baseball and an orange are alike, he responded,
“They both are alive.”The patient’s immediate and recent memories were slightly impaired, although his remote mem-
ory was intact. It is estimated that he is of average intelligence. Currently, his insight and judgment appear to be poor.
THE ASSESSMENT INTERVIEW 177