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Mental Status Examination

How would you proceed with the MSE if the medical or genetic history was unavailable to you at the time of the MSE? Do you believe that other factors such as culture, race, or religion are more important or less important than genetic factors.  Considering all of the factors that are involved with competency, do you think that it is fair and accurate to pinpoint any one or two major factors as the ultimate determinates in each individual case. 200 words at least one intext citation