| ARCHETYPE ID | openEHR-EHR-OBSERVATION.mental_state.v0 |
|---|---|
| Concept | Mental state examination (MSE) |
| Description | A structured assessment about the current state of mind of an individual. |
| Use | Use to record a structured assessment about the current state of mind of an individual. Assessment and interpretation of the MSE must be appropriate for age, gender, cultural background, clinical context, etc. |
| Purpose | To record a structured assessment about the current state of mind of an individual. |
| References | rch.org.au/clinicalguide/guideline_index/Mental_state_examination/ |
| Copyright | © openEHR Foundation |
| Authors | Author name: Heather Leslie Organisation: Atomica Informatics Email: heather.leslie@atomicainformatics.com Date originally authored: 2019-12-20 |
| Other Details Language | Author name: Heather Leslie Organisation: Atomica Informatics Email: heather.leslie@atomicainformatics.com Date originally authored: 2019-12-20 |
| Other Details (Language Independent) |
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| Keywords | |
| Lifecycle | in_development |
| UID | 34c0eb40-c6a4-47c3-a0ff-079b7e1d4fb5 |
| Language used | en-au |
| Citeable Identifier | 1013.1.4512 |
| Revision Number | 0.0.1-alpha |
| events | |
| Any event | Any event: * |
| data | |
| Appearance | Appearance: Description about the observed physical appearance of an individual. Commonly, this data will be recorded as a narrative description. This data element has multiple occurrences to support multiple choice coded values to be recorded. Including but not limited to: body habitus, grooming, hair/dress style, and apparent age. |
| Attitude | Attitude: Description about the observed attitude of an individual. Commonly, this data will be recorded as a narrative description. This data element has multiple occurrences to support multiple choice coded values to be recorded. Including but not limited to: body habitus, grooming, hair/dress style, and apparent age. |
| Behaviour | Behaviour: Description about the observed behaviour of an individual. |
| Mood | Mood: Description about the observed mood of an individual. |
| Affect | Affect: Description about the observed affect of an individual. |
| Speech | Speech: Description about the observed speech of an individual. |
| Thought form | Thought form: Description about the observed form of thought of an individual. |
| Thought content | Thought content: Description about the observed content of thought of an individual. |
| Perceptions | Perceptions: Description about the observed perceptions of an individual. |
| Cognition | Cognition: Description about the observed cognition of an individual. |
| Insight | Insight: Description about the observed insight of an individual. |
| Judgement | Judgement: Description about the observed judgement of an individual. |
| Additional details | Additional details: Further structured details about the mental status examination and its components. Include: All not explicitly excluded archetypes |
| Comment | Comment: Additional narrative about the mental state examination not captured in other fields. |
| protocol | |
| Extension | Extension: Additional information required to capture local content or to align with other reference models/formalisms. For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents. Include: All not explicitly excluded archetypes |
| Other contributors | |
| Translators |