🔍 Mental State Examination

Apparent age, dress, grooming, hygiene, posture, gait, eye contact, rapport, engagement, psychomotor activity, abnormal movements and response to internal stimuli. Describe observations without judgement.

• Routine psychiatric assessment combines a general medical and psychiatric evaluation with a mental status examination (1). Visual inspection plus interaction yield most of the findings.

Speech: amount, rate, volume, fluency, prosody and latency. Mood: patient's sustained internal emotional state, preferably in their words. Affect: observed quality, range, intensity, reactivity, stability and congruence.

Thought form: coherence, goal direction, associations, blocking, flight of ideas, circumstantiality or tangentiality. Thought content: delusions, overvalued ideas, obsessions, guilt, hopelessness, self-harm, suicide and violence. Perception: hallucinations, illusions, dissociation and insight into experiences.

Level of consciousness, attention, orientation, memory, language and executive function as indicated. Insight includes recognition of change/illness, explanation and need for care. Judgement is assessed through recent decisions and hypothetical reasoning; capacity is decision-specific and assessed separately.

Document suicide, self-harm, violence, vulnerability, self-neglect, dependants and safeguarding. Quote brief examples for unusual speech or beliefs. End with a concise formulation, differential and plan rather than a checklist alone.