Mental Status Examination: Fill & Download for Free

A slightly different take on Trump’s “dissociation from reality.”On May 1, 2017, John Dickerson interviewed Trump in the oval office (President Trump's interview in the Oval Office: Full Transcript). In that interview, an exchange occurred that should have gotten the attention of every neurologist, psychiatrist, mental health professional, and geriatrician in the country. The video is chilling from the perspective of clinicians trained in the administration of the Mental status examination. This is an excerpt from the transcript.“JOHN DICKERSON: George W. Bush said the reason the Oval Office is round is there are no corners you can hide in.PRESIDENT DONALD TRUMP: Well, there's truth to that. There is truth to that. There are certainly no corners. And you look (Trump points towards the windows), there's a certain openness. But there's nobody out there. You know, there is an openness, but I've never seen anybody out there actually, as you could imagine.JOHN DICKERSON: But he-- what he meant was it's-- all comes --PRESIDENT DONALD TRUMP: Sure. Sure.”Why do I say it’s chilling? Dickerson is quoting a meta-comment made, by of all people, George W. Bush. Trump’s reply is resolutely concrete, meaning very literal. “Concrete” is the term we use when an answer to a question fails to acknowledge the meta implications of a statement or question. Typically, in mental status testing, we ask patients to interpret a proverb, like “What’s it mean to say you shouldn’t cry over spilled milk?” Cognitively normal people immediately realize that the question is not about “spilling milk.”Trump’s initial response, “There are certainly no corners” is as literal as possible, but he persists. The second part is a concrete riff on the concept “you can’t hide” in which Trump explains the lack of corners is not important because no one can see in through the Oval Office windows (towards which he is pointing), “I've never seen anybody out there.” He completely misses the figurative implications of Bush’s comment, which had nothing at all to do with “corners” or “hiding.”In the video of the interview, Dickerson is visibly appalled, as he should have been, by Trump’s answer and he attempts to direct Trump to the implications of the quotation. Trump immediately senses the implied rebuke and becomes hostile.So Dickerson unwittingly performed a mental status exam on Trump and videotaped it for us all to see. This adds to the linguistic analysis of Trump’s speech patterns that was recently made public.My impression, based on this interview and the linguistic analysis is that Trump has Mild cognitive impairment, quite possibly* early dementia.The Mental Status ExamProverb familiarity and the mental status examination.Experts Say Trump's Deteriorating Speech Could Be Sign of Early DementiaCompare this old interview with recent ones: A Newly Discovered Video Shows Trump Bragging About Doing Exactly What Comey SaidMild cognitive impairment - WikipediaFusionBrain Specialist Believes Donald Trump’s Frontal Lobe is FailingResearchers find new early clues pointing to onset of Alzheimer’s diseasePsychiatrists are speaking out: https://www.scientificamerican.com/article/psychiatry-group-says-members-can-comment-on-trump-rsquo-s-mental-health/?utm_source=facebook&utm_medium=social&utm_campaign=sa-editorial-social&utm_content=link-post&utm_term=mind_partner_text_freeScientific American60,000 Psychologists Say Trump Has "Serious Mental Illness"Scott Gosnell's answer to What is the history of the 'Goldwater Rule' and why have the American Psychiatric Association, the American Psychological Association and the American Psychoanalytic Association decided to waive it with regard to Donald J. Trump?*Over five years, 50% of people with Mild cognitive impairment progress to frank dementia. However other explanations for his MCI exist. For instance, his morbid obesity puts him at grave risk for Obstructive sleep apnea, which could impair cognition.

The question is paradoxical because “non-physical” “brain damage” is an oxymoron. The brain and its functions are physical, not metaphysical.If the intent of the question regards how diagnoses are made for brain problems not obvious on physical exam, EEG or MRI, then the answer involves the Mental status examination and Neuropsychological assessment.All clinicians learn a serviceable Mental Status Exam. Neurologists, Psychiatrists, Psychologists and Clinical Social Workers specialize in its use with slightly different emphases. Neurologists often are more concerned with cognitive issues (dementia, obscure localization issues such as Gerstmann’s syndrome), while the others are somewhat more attentive to thought disorders and affective issues. The overlap of concerns is immense.All these clinicians make liberal use of neuropsychologists (Neuropsychology). Their skill set includes the Mental Status Exam, but is backed by standardized, sometimes quantitative, testing that can provide important, often subtle, insight.

When you have a broken leg, whether you are a Republican or Democrat, who do you go to? Do you go to Donald Trump, the man who lent the power of his office to help the virus along or do you go to your doctor?You go to Trump for advice and I’ll go to my doctor and we’ll see who is walking sooner.Trump has never predicted anything accurately. He calls himself a genius but in my humble opinion, he needs a mental status examination. He ignored the advice of experts who warned him but as usual, he knows it all and was unmoved.When Trump allowed the virus to get out of control, it merely followed his usual incompetence. The least he could do is resign or step out of the way and let the professionals do their job.He has to appear every day for his usual campaigning for reelection, thankfully, it has backfired and he only looks more stupid than he already is.It’s no longer about politics, it’s about survival and the lives of our descendants. Remember them? It isn’t about you and it isn’t about Trump. It’s time the chief got over himself and did his job or got out of the way and let the professionals do theirs.