Mental Status Examination: General: LoC:Level of Consciousness: [select value="alert & oriented in all spheres|obtunded|disoriented"]. [select name="variable_1" value="Conscious|Alert & Oriented x4|In No Acute Distress|Attentive|Conscious Alert & Oriented Times Four In No Acute Distress.|Drowsy|High Strung |Inappropriate|Intoxicated|Lethargic|Relaxed|Withdrawn"] presents [select value="alert & oriented to |disoriented to |"][select value="person, place, & time|"]. [select value="Recent & remote memory intact|Recent memory intact, although issues w/ remote memory include |Remote memory intact, although issues w/ recent memory include |Issues w/ recent & remote memory noted to be |"]. [select value="Attention span & concentration adequate|Difficulty w/ attention span & concentration evidenced "]. Participation Appearance: Appearance-:ADLS:[select name="variable_1" value="Poor Grooming/Hygiene|Poor Adls|Normal Grooming & Hygiene|Fair Grooming;Hygiene|Fair Adls|Good Adls|Clothing|Adequately Dressed & Groomed;|Clothing: Appropriate|Bizarre, Inappropriate|Casual Dress|Clothing Atypical, Unusual,|Clothing Disheveled|Dirty/ Unkempt|Fastidious|Neat/Clean|Inappropriate For Weather|Inappropriate / Bizarre|Messy/Unkempt|Physically Unclean|Unkempt|Unshaven|Well Groomed|Unusual|Normal"] Weight Appearance: Grooming [select value="well kempt|poorly kempt|appropriately dressed|inappropriately dressed|appropriately groomed|inappropriately groomed"]. appears to be [select value="stated age|younger than stated age|older than stated age|"]. [select value="well groomed|unkempt|"], [select value="appropriately dressed|inappropriately dressed|"], w/ [select value="normal posture|slumped posture|rigid posture|"]. behavior [select value="calm|restless|agitated|irritable|anxious|impulsive|"], & [select value="interactive|inattentive|withdrawn|"][select value=" w/ good eye-contact| w/ intermittent eye-contact| w/ avoidant eye-contact"] 1) General Appearance :Physical Characteristics: [select name="variable_1" value="Weight: Normal.|Slender|Emaciated|Mildly Obese|Mod Obese|Grossly Obese|"] [select name="variable_1" value="Appears Stated Age|Appears Older Than Stated Age|Appears Younger Than Stated Age"][select name="variable_1" value="Avg Height|Above Avg Height|Below Avg Height"] Clothing [select name="variable_1" value="Unusual Physical Characteristics|Deformities"] [select name="variable_1" value="Appropriate|Adequately Dressed & Groomed |Inappropriate for Weather|Bizarre"] 3) Speech A. Quantity [select name="variable_1" value="Blocking|Brief|Expansive|Hyperverbal|Minimal|Mute/Non-Verbal|Paucity|Perseveration, Echolalia, Stammering, Mute, Clanging, Aphasia|Sparse|Talkative"] B. Rate Speech [select value=" regular rate & rhythm|rapid|slow|"][select value=", spontaneous|, appears prepared|"][select name="variable_1" value="Accelerated|Decreased, Slowed|Hesitant|Hurried; Pressured |Labored|Pauses/Pausing|Rapid|Redundant|Response Latency|Slow, Deliberate|Spontaneous|Thoughtful"] C. Volume (Tone) [select value=", fluid, slurred|, monotone|, pressured|, laconic|"][select value=", normal volume|, quiet|, loud|"]. [select name="variable_1" value="Deliberate|High Emotional Tone|Increased, Loud|Listless, Repetitive w/ Flat Tone|Low Emotional Tone|Low Energy|Monotone|Quiet|Rate/Tone/Volume W/Out Pressure| Rhythm, Rate, Tone|Soft|Strong |Weak"]:Speech Quality *Voice*: [select name="variable_1" value="Affected|Atypical |Childlike Voice|Clear|Harsh Quality|Monotonic|Raspy|Singing, Lulling Quality|Squeezed Voice"] D. Fluency & Rhythm [select name="variable_1" value="Abnormal|Aggressive|Appropriately Placed Inflections|Coherent & Spontaneous|Expressive|Flow|Gasping While Talking|Good Articulation|Mechanical|Mumbling|Punctuating|Rhythm|Slurred |Staccato|Stammer/Stutter |Stereotyped;Unremarkable"] [select name="variable_1" value="Blocking|Brief|Expansive|Hyperverbal|Minimal|Mute/Non-Verbal|Paucity|Perseveration, Echolalia, Stammering, Mute, Clanging, Aphasia|Sparse|Talkative"] :*Verbal Content*: Language skills [select value="adequate, |limited, |difficult to assess due to degree of symptomatic presentation|"][select value="& consistent w/ education|& inconsistent w/ education|"]. Vocabulary [select value="adequate|large|limited|difficult to assess due to symptomatic presentation|"] :Use Of Words; Language:[select name="variable_1" value="Abusive|Condemnation|Elation|Fear / Anxiety|Illogical|Immature|Insight|Paranoid|Patterns, Tics (“You Know”)|Persecution|Self-Condemnation|Tangential|Trails Off In Their Thoughts|Laughter|Elation-Expansive|High Animation/Gesturing While Talking Quantity - [select name="variable_1" value="Deviations: None| Aphasia, Neologisms|English Speaking & Fluent|Incoherent|Intelligibility|Language"] 4)Behavior | General Body Movements | [select name="variable_1" value="Accelerated |Activity:Normal |Agitated|Atypical, Peculiar, Inappropriate |Bizarre|Calm|Decreased, Slowed|Excited |HyperactiveHypermotor|Hypoactive Hypomotor|Impulsive|Increased |Interactive|No Gross Behavioral Abnormalities|Pacing|Restless|Restlessness, Fidgety|Slowed |Unable To Sit Still |Unusual Eye Contact[select name="variable_1" value="Appropriate|Avoidant|Brief|Distracted|Downcast|Fair|Fleeting|Good|Intense|Intermittent|Piercing|Poor|Rapid Blinking|Wnl"] Gait/Posture|Motor Activity: [select name="variable_1" value="Gait|Unusual Motor Activity|Use Of Hand Gestures To Communicate |Wring Hands"] [select name="Posture " value="Hunched Over|Relaxed| Rigid/Tense |Slumped |Stereotyped |Stiff|Stooped |WNL"][select name="variable_1" value="Gait/Posture: Normal.|Motor Activity: Smooth/Unremarkable.|Wnl|Appropriate &Alert|Atypical|Avoidant|Calm & Cooperative|Presents Calm, Attentive, & Relaxed|Uncooperative"] Gait[select value="normal|abnormal|unsteady|shuffling|spastic"]. Behavior - eye contact: [select value="Appropriate|Avoidant|Brief|Distracted|Downcast|Fair|Rapid Blinking|Fleeting|Good|Intense|Intermittent|Piercing|Poor|Wnl"]. Behavior - general: [select value="in no acute distress|in acute psychological distress"]. Behavior - interactivity/stability [select value="warm w/ comments & behavior|iAbrasive |Aggressive|Agitated |Aloof|Angry|Antagonistic|Apathetic / Detached |Calm & Cooperative|Clinging|Composed|Cooperative |Cooperative & Attentive |Defensive |Demanding|Dependent|Direct|Distant|Docile|Domineering|Dramatic |Engaging|Fearful|Friendly|Guarded |Guarded; hostile|Guarded; Oppositional|Hostile|Hyperactive|Impulsive |Inattentive |Indifferent|Inhibited|Interactive |Introverted|Irritable |Manic|Manipulative|Oppositional|Outgoing|Overbearing|Overly Compliant; Passive|Provocative|Requires Assurance|Restless |Self-Assured|Shy|Stubborn|Subdued|Submissive|Suspicious; Mistrustful|Timid|Uncooperative / Defiant|Unusual/Bizarre |Warm|Withdrawn"] Mood Is Mood/Affect - congruence: [select value="mood congruent w/ affect|mood & affect not congruent"].Mood/Affect - emotional range: [select value="normal|broad|restricted"].Mood/Affect - intensity: [select value="normal|expansive|blunted|flat"].Mood/Affect - stated: [select value="normal|upbeat|euthymic|depressed"].[select name="variable_1" value="Absent|Affect Congruent w/ Mood |Agitated|Angry/Irritable|Annoyed|Anxiety/Anxious|Apathetic;Apathy|Apprehension/apprehensive|Blunted|Body Posture & Attitude Convey Underlying Depressed Mood |Congruent|Content|Defensive |Depressed/Depressed Mood|Dysarthric/Dysphoria|Dysphoria/Dysphoric /Sadness|Elation/Euphoria|Elevated |Euthymia/Euthymic|Facial Expression & General Demeanor Reveal Depressed Mood|Fear/Fearful|Flat|General Discontent|Guilt/Guilty|Happy|Hopelessness|Hostile;Hostility|Hyperverbal|Impaired|Inappropriate To Thought Content|Incongruent|Increased Lability Of Affect|Irritable|Labile/Lability (Rapid Change In Moods)|Less Depressed|Loss Of Interest/Loss Of Interest / Pleasure In Activities|Manic |Manipulative |Mood Euthymic|Mood Swings|Normal / Good|Oppositional |Other|Restricted|Sad/Depressed|Shallow|Silly |Stressed|Superficial|Tearful |Unvarying Euphoria|Wnl"] Affect Is [select name="variable_1" value="Congruent w Mood|Incongruent w Mood"] [select name="variable_1" value="Anxious|Defiant|Depressed|Detached|Elated|Fair|Flat|Inappropriate|Incongruent|Mistrustful|Paranoid|Passive|Pleasant|Sad|Silly|Unusual/Bizarre"][select name="variable_1" value="Angry;Hostile|Anxiety; Fear;Apprehension|Decreased Expression|Depression, Sadness|Guarded|Nervous|Poor Eye Contact"] Cognition/Memory - abstraction: [select value="normal ability to abstract|difficulty w/ abstract thought|inability for abstract thought"]Cognition/Memory: [select value="normal|grossly intact|below average|above average"].Perception - general: [select value=normal|normal - denied any preoccupations, obsessions, delusions, hallucinations / perceptual disturbances"] Perception - insight: [select value="normal insight|poor insight"]Thought form & content: [select value="normal|future oriented|logical, linear & goal-oriented|past oriented & somber|goal directed|scattered|hopeful|remorseful|enthusiastic|resigned"]Judgment: [select value="normal|poor|good"]. Concentration[select name="variable_1" value="Appropriate |option B|option C"][select name="variable_1" value="Normal |option B|option C"][select name="variable_1" value="Normal||option C"][select name="variable_1" value="option |option B|option C"][select name="variable_1" value="option |option B|option C"]Good/Neat [radio name="variable_1" value="Intact |Normal/Unremarkable|choice B|choice C"] Thought processing & content [select value="adequate, |delayed, |"][select value="logical, |illogical, |"][select value="reality based|"][checkbox name="thoughts" memo="additional descriptors" value=""][conditional field="thoughts" condition="(thoughts).is('')"][checkbox value="disorganized|circumstantial|tangential|flight of ideas|loose association|perseveration|thought blocking|ideas of reference|grandiose|paranoid|persecutory|religious|somatic|self accusatory"][/conditional]. [select value="No evidence of hallucinations / delusions|Hallucinations/delusions characterized "]. [select value="No evidence of preoccupation w/ violence|They have reoccupation w/ violence evidenced by [text name="variable_1" default="sample text"]'[select value="They deny suicidal ideation|They report positive for suicidal ideation without intent|They report positive for suicidal ideation w/ intent |"]. [select value="denies homicidal ideation|They affirm homicidal ideation toward |"]. judgment [select value="good|fair|poor|impaired|"]. insight concerning psychiatric condition [select value="good|fair|poor|impaired|"] Attention: [select value="no difficulty w/ attention / concentration|had some attentional & concentration problems during exam"]. fund of knowledge [select value="appropriate for stated age & education level|inappropriate for stated age & education level|difficult to assess due to symptomatic presentation|"]. [select value="capable of abstraction| displays difficulty w/ abstraction|Assessment of abstraction ability difficult due to symptomatic presentation"]. currently assessed to be [select value="low|moderate|high"] risk for self harm / harm to others evidenced by ideation & behavior on today's exam. Other:[select name="variable_1" value=" Denies Suicidal / Homicidal Ideation, Intent, Plan / Means |There No Loosening Of Associations & Cognition Appears Generally Well Ordered |Insight, Judgment & Impulse Control Within Normal Limits|Cooperative w Interview "] Suicide/Assault: [select value="no current / past ideation / intent|denies active sense of wanting to harm self / others|present but without intent / plan|resolved"].
There are 80 form elements.