MSE UK 2

Mental State Examination:

Appearance:
- general: [select value="appears to be of chronological age|appears younger than chronological age|appears older than chronological age|unknown"]
- build: [select value="average height|tall    stature|    short    stature|unknown"], [select value="average weight|slim    build|appears    overweight|appears    obese|appears    underweight|unknown"] 
- grooming: [select value="well presented|no self-neglect evident|some self-neglect    evident|dishevelled    appearance|self-neglect    and    malodour noted|smell of alcohol noted|unknown"]
- dress: [select value="clean|soiled clothing    noted|unkempt|neat and    tidy|meticulous|worn out|bizarre|unconventional|fashionable|professional"], [select value="appropriate for season|    inappropriate to season|unknown"], [select value="appropriate for setting|inappropriate for setting|unknown"] 
- significant features: [select    value="nil noted|scarring noted|cuts noted|   tattoos evident|physical injury    evident"]
- posture: [select value="quietly seated|relaxed|stooped|tense|hyperactive|agitated|rigid|shaky|slouched|bizarre movements|posturing|crouching|restless|unknown"]
- gait: [select value="normal|hyperactive|slow|retarded|agitated|hesitant|propulsive|shuffling|dancing|ataxic|uncoordinated|unknown"]

Behaviour: 
- general: [select value="in no distress|in mild psychological distress|in moderate psychological distress|in acute psychological distress"]
- facial expression: [select value="normal|limited|flat|sad|perplexed|rapidly changing|angry|tense|grimacing|unknown"]
- eye contact: [select value="appropriate|avoidant|decreased|heightened|fixed|unknown"]
- motor activity: [select value="normal|tense|hyperactivity|retardation|akathisia|automatism|evidence    of catatonia"]
- movements: [select value="nil abnormal noted|agitated|compulsions|grimaces|tics|twitches|foot tapping|rocking back and forth|hand wringing|ritualistic behaviour|mannerisms|posturing|nail biting|chewing movements|echopraxia|tardive dyskinesia|catatonic|dystonia"]
- attitude and cooperativeness: [select value="open|shy|candid|cooperative|friendly|uncooperative|irritated but not to the level of anger|angry|alert|confused|hostile|silent|inappropriate boundaries|seductive|playful|ingratiating|evasive|guarded|sullen|manipulative|contemptuous|demanding|defensive|withdrawn|suspicious|secretive|easily distracted"]

Speech: 
- quantity: [select value="within normal limits|responds only to questions|poverty of    speech|mute|talkative|expansive|repetitive"]
- quality: [select    value="precise|monotonous|emotional|hesitant|rambling"]
- rate: [select value="normal |fast|slow|delayed    onset|pressured"]
- volume: [select    value="loud|soft|weak|quiet|mute|normal"]
- clarity: [select value="clear|good    articulation|slurred|hesitant|mumbled|lisping|stuttering|inaudible|incoherent|long pauses|dysarthria|echolalia|perseveration"]
 
Mood: [select value="calm|comfortable|euphoric|anxious|scared|depressed|tearful|labile|flat|happy|sad|irritated|angry|enraged|euphoric|guilty|other (describe)"]
Affect: 
- quality: [select value="euthymic|hyperthymic|elevated|dysphoric||irritable|anhedonic"]
- range: [select value="broad|restricted|blunted|flat|labile|excited"]
Congruency: [select value="congruent to mood|not congruent to mood"] 

Thought:
- form and flow: [select value="logical,relevant,and goal orientated|disorganised|incoherent|past orientated|scattered|impoverished|racing thoughts|circumstantial|perservations|flight of ideas|illogical|hopeful|remorseful|enthusiastic|incoherent|neologism|distractable|tangential|overvalued ideas|excited|poverty of thought|word salad|clang associations|slow reaction|rapid reaction|doubting|indecisive|blocking|spontaneous|pressured|concrete"]
- content: [select value="within normal limits|distortions|ruminations|thought withdrawal|thought insertion|paranoia|thought broadcast|suspiciousness|grandiose delusions|persecutory    delusions|somatic delusions|delusional guilt|nihilistic delusions|ideas of reference|ideas of inference|magical thinking|somatic preoccuptaions|obsessions|compulsions|phobias"], [select value="|    |within normal limits|distortions|ruminations|thought withdrawal|thought insertion|paranoia|thought broadcast|suspiciousness|grandiose delusions|persecutory    delusions|somatic delusions|delusional guilt|nihilistic delusions|ideas of reference|ideas of inference|magical thinking|somatic preoccuptaions|obsessions|compulsions|phobias"],[select value="|    |within normal limits|distortions|ruminations|thought withdrawal|thought insertion|paranoia|thought broadcast|suspiciousness|grandiose delusions|persecutory    delusions|somatic delusions|delusional guilt|nihilistic delusions|ideas of reference|ideas of inference|magical thinking|somatic preoccuptaions|obsessions|compulsions|phobias"] 

Perception: [select value="within normal limits|illusions|auditory hallucinations|visual    hallucinations|tactile    hallucinations|gustatory    hallucinations|olfactory    hallucinations|multimodal    hallucinations| hypnogognic    hallucinations|hypnopompic    hallucinations|depersonalisation|derealisation"], [select value="|    |within normal limits|illusions|auditory    hallucinations|visual    hallucinations|tactile    hallucinations|gustatory    hallucinations|olfactory    hallucinations|multimodal    hallucinations|hypnogognic    hallucinations|hypnopompic    hallucinations|depersonalisation|derealisation"], [select value="|    |within normal limits|illusions|auditory    hallucinations|visual    hallucinations|tactile    hallucinations|gustatory    hallucinations|olfactory    hallucinations|multimodal    hallucinations|hypnogognic    hallucinations|hypnopompic    hallucinations|depersonalisation|derealisation"]
 
Cognition:
- orientation: [select value="orientated to person,place,time and event|not orientated to person, place, time and event|lethargic|obtundation|stupor|coma"]
- attention: [select    value="adequate|distracted|diminished|hypervigilant|selective"]
- memory: [select value="no impairment|grossly intact|below average|above average|short-term memory loss|long-term memory loss|amnesia|anterograde amnesia|retrograde amnesia| history of head trauma|transient global amnesia"] 
- concentration: [select    value="no concerns noted|easily distracted|often    distracted|poor"]

Risk:
- suicidality: [select value="no current ideation, plan or intent|past ideation only|past ideation and plan only|past ideation, plan, and intent|previous attempt/s|current ideation, no current plan or intent|current ideation and plan, no current intent|current ideation, plan, and intent|current ideation, plan, intent and available means"] 
- self-injurious behaviour: [select value="no current ideation, plan or intent|actively self-harming|past ideation only|past ideation and plan only|past ideation, plan and intent|previous attempt|current ideation, no current plan or intent|current ideation and plan, no current intent|current ideation, plan and intent"]
- homicidality/harm to others: [select value="no current ideation, plan or intent|past ideation only|past ideation and plan only|past ideation, plan and intent|previous attempt|current ideation, no current plan or intent|current ideation and plan, no current intent|current ideation, plan and intent"]
- impulse control: [select    value="normal|impaired"]

Insight: [select value="good|limited|nil"]  
Judgement: [select value="good|fair|poor"]

Additional information: [textarea cols="80" rows="3" default= "Nil"]