Finney Glen R, Minagar Alireza, Heilman Kenneth M
Geisinger Health System Neurology, Wikes-Barre, PA 18711, USA.
Department of Neurology, Louisiana State University Health Sciences Center - Shreveport, 1501 Kings Highway, Shreveport, LA 71130, USA.
Neurol Clin. 2016 Feb;34(1):1-16. doi: 10.1016/j.ncl.2015.08.001.
Assessing the mental status of patients with a neurobehavioral disorder is a critical element in the diagnosis and treatment of these patients. This assessment should always be performed after the patient's history it taken and a general physical as well as a neurologic examination is completed. The mental status examination commences with observing the patient's appearance and level of consciousness. The examiner should also pay attention to patient's social behavior, emotional state and mood. There are 3 major means of assessing a patient's mental status. One type attempts to determine if the patient is demented and the severity of the dementia as it pertains to their ability to perform activities of daily living as well as instrumental activities. A second type of assessment utilizes what may be termed as "screening tests" or "omnibus tests". These brief tests are performed independent of the patient's history and examination. The two most frequently used screening tests are the Mini-Mental Status Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The third means of assessing a patient's mental status is by using specific neuropsychological tests that focus on specific domains of cognition, such as frontal executive functions, attention, episodic verbal and visuospatial memory, declarative knowledge such as language (speech, reading and writing) and arithmetical, as well as visuospatial and perceptual abilities. These neurobehavioral, neuropsychiatric and neuropsychological assessments of patients with a cognitive decline and behavioral abnormalities should often be accompanied by laboratory tests, and neuroimaging that can help determine the underlying pathologic process so that effective therapeutic and management approaches can be provided.
评估患有神经行为障碍患者的精神状态是这些患者诊断和治疗的关键要素。这种评估应始终在获取患者病史并完成全面体格检查以及神经学检查之后进行。精神状态检查始于观察患者的外貌和意识水平。检查者还应注意患者的社会行为、情绪状态和心境。评估患者精神状态有3种主要方法。一种类型试图确定患者是否患有痴呆症以及痴呆症的严重程度，这与他们进行日常生活活动以及工具性活动的能力有关。第二种评估类型利用可称为“筛查测试”或“综合测试”的方法。这些简短测试独立于患者的病史和检查进行。最常用的两种筛查测试是简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）。评估患者精神状态的第三种方法是使用专注于特定认知领域的特定神经心理学测试，例如额叶执行功能、注意力、情景言语和视觉空间记忆、陈述性知识（如语言（言语、阅读和写作）和算术）以及视觉空间和感知能力。对认知能力下降和行为异常患者的这些神经行为、神经精神和神经心理学评估通常应伴有实验室检查以及神经影像学检查，这有助于确定潜在的病理过程，从而提供有效的治疗和管理方法。
