What is the role of a mental status exam in patients with panic disorder?

Updated: Mar 21, 2018
  • Author: Mohammed A Memon, MD; Chief Editor: Randon S Welton, MD  more...
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Answer

No results on the mental status examination are specific for panic disorder. The patient may or may not appear anxious at the time of interview, and the results on his or her Mini-Mental Status Examination, including cognitive performance, memory, serial-7, and proverb interpretation, should appear intact and consistent with the patient’s educational level and apparent baseline intellectual functioning.

During a panic attack, a mental status examination may reveal extreme anxiety, fear, and a sense of impending death or doom. The patient may have difficulty speaking as well as appear sweaty and confused. The patient’s speech may reflect anxiety or urgency, or it may sound normal, and the individual’s mood may be described as similar to "anxious," with congruent affect. Incongruent affect should raise consideration of other diagnostic possibilities.

The patient’s thought processes should be logical, linear, and goal directed. Thought content is particularly important to specifically assess in order to ensure that a patient has no suicidal or homicidal thoughts. Acute anxiety, as a form of acute mental anguish, can lead to unsafe or self-injurious behavior. Abnormalities in thought process or thought content (aside from impulsive suicidal thoughts) should prompt reconsideration of other etiologies. Insight and judgment are usually present and intact.


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