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Mental Status Examination:
General: [select name="variable_2" value="alert and oriented in all spheres|obtunded|disoriented"].
Appearance: [select name="variable_3" value="well kempt|poorly kempt|appropriately dressed|inappropriately dressed|appropriately groomed|inappropriately groomed"].
Behavior - general: [select name="variable_4" value="in no acute distress|in acute psychological distress"].
Behavior - stability: [select name="variable_5" value="calm|agitated"].
Behavior - interactivity: [select name="variable_6" value="warm with comments and behavior|interactive|withdrawn"].
Behavior - eye contact: [select name="variable_7" value="eye contact good|eye contact fair|eye contact avoidant"].
Mood/Affect - stated: [select name="variable_8" value="normal|upbeat|euthymic|depressed"].
Mood/Affect - emotional range: [select name="variable_9" value="normal|broad|restricted"].
Mood/Affect - intensity: [select name="variable_10" value="normal|expansive|blunted|flat"].
Mood/Affect - congruence: [select name="variable_11" value="mood is congruent with affect|mood and affect are not congruent"].
Thought form and content: [select name="variable_12" value="normal|future oriented|logical, linear and goal-oriented|past oriented and somber|goal directed|scattered|hopeful|remorseful|enthusiastic|resigned"]
Attention: [select name="variable_13" value="no difficulty with attention or concentration|had some attentional and concentration problems during the exam"].
Perception - insight: [select name="variable_14" value="normal insight|poor insight"]
Perception - general: [select name="variable_15" value=normal|normal - denied any preoccupations, obsessions, delusions, hallucinations or perceptual disturbances"]
Cognition/Memory: [select name="variable_16" value="normal|grossly intact|below average|above average"].
Cognition/Memory - abstraction: [select name="variable_17" value="normal ability to abstract|difficulty with abstract thought|inability for abstract thought"]
Judgment: [select name="variable_18" value="normal|poor|good"].
Suicide/Assault: [select name="variable_19" value="no current or past ideation or intent|denies an active sense of wanting to harm self or others|present but without intent or plan|resolved"].
Patient is currently assessed to be at [select name="variable_20" value="low|moderate|high"] risk for self harm or harm to others as evidenced by ideation and behavior on today's exam.
Mental Status Examination:
General: .
Appearance: .
Behavior - general: .
Behavior - stability: .
Behavior - interactivity: .
Behavior - eye contact: .
Mood/Affect - stated: .
Mood/Affect - emotional range: .
Mood/Affect - intensity: .
Mood/Affect - congruence: .
Thought form and content:
Attention: .
Perception - insight:
Perception - general:
Cognition/Memory: .
Cognition/Memory - abstraction:
Judgment: .
Suicide/Assault: .
Patient is currently assessed to be at risk for self harm or harm to others as evidenced by ideation and behavior on today's exam.

Result - Copy and paste this output:

5 responses to “Mental Status Examination”

  1. Anonymous says:

    Hello, This is an awesome tool. I recommend adding a feature that places input data into a summary form – to be copied – in the results section (once calculated).

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