MSE Command Centre
A structured workspace for the mental state examination — organised as a five-level model, not a flat checklist. Work each domain through the same six operations, and let the examination structure lead you into the knowledge.
Start a training MSE- Observation before interpretation; description before diagnosis.
- Do not diagnose from a single symptom.
- Keep thought FORM separate from thought CONTENT.
- Keep MOOD (subjective) separate from AFFECT (observed).
- Keep PERCEPTION separate from BELIEF.
- Absence of evidence is not evidence of absence — say what was and was not elicited.
- Do not use 'normal' without naming the domain observed.
- Do not treat unfamiliar cultural or religious experience as pathology without contextual assessment.
- This is an educational instrument, not a diagnostic or emergency tool.
The six operations
- Observe Record only what is directly observable in this domain — the facts, before any meaning is attached.
- Elicit Ask open, non-leading questions to bring out the experience in the patient's own words.
- Clarify Follow up to pin down the exact quality of the experience (ownership, agency, source, conviction, control, context).
- Classify Name the phenomenon precisely using descriptive-psychopathology vocabulary — not a diagnosis.
- Differentiate Distinguish it from the phenomena it is most often confused with; find the single discriminating fact.
- Document Write the finding so that observation, patient report and clinician inference stay clearly separated.