Training-only MSE. For educational and supervision purposes.
Created: 22 Jan 2026, 02:27
Student: Tanisha
Batch: Jan19
Client / Case Name: Aanya, 19 year old college student
Date of assessment: 22-01-2026
Appears stated age, female Moderately groomed, hygiene maintained Looks tired and slightly low in energy Dressing appropriate and neat Eye contact: minimal to fair Posture: slightly slumped
Mild psychomotor retardation (slow movements) No agitation, no abnormal movements Normal gait and posture
Cooperative and polite, Slightly reserved/guarded initially, Answers relevantly, engages with prompts.
Conscious, alert and responsive Oriented to time, place and person
Speech: soft, low volume Rate: slow Tone: monotonous Coherent and relevant No pressure of speech, no slurring
Mood (subjective): “Sad and stressed most of the time.” Mood (objective): Depressed/anxious. Affect: Constricted, reduced range, mood-congruent, mildly reactive, appropriate to context.
a. Thought Process:
Thought process is logical, coherent and goal-directed but slightly slowed; no loosening of associations, flight of ideas, or tangentiality noted.
b. Thought Content:
Preoccupation with academic stress and future-related worries; negative automatic thoughts (self-doubt, low self-worth) and guilt present. No delusions, obsessions, or phobias reported. Client denies active suicidal ideation/plan; occasional passive death wishes (“I wish I could disappear”) during intense stress. No homicidal ideation.
No hallucinations (auditory/visual/tactile) reported. No illusions, depersonalization, or derealization
Orientation: Oriented to time, place and person. Attention & Concentration: Mildly impaired; distractible due to overthinking. Memory: Immediate, recent and remote memory intact. Intelligence: Average (as per educational functioning).
Personal judgment: Fair (able to make basic day-to-day decisions but indecisive due to overthinking). Social judgment: Intact (understands social norms and behaves appropriately). Test judgment: Fair (able to respond appropriately to hypothetical situations, seeks help when needed).
Client has partial insight into her condition; she recognizes emotional difficulties and the need for support. Insight Grade: Grade IV (Acknowledges illness and need for help).
Handedness: Right-handed Language assessment: Speech coherent and relevant; understands questions well; no language impairment noted. Psychomotor abnormalities: Mild psychomotor retardation; no catatonia/agitation.
Short title / summary: (not filled)
(no extra notes)