Mental state assessment: Specific conditions

Mental state assessment or mental state examination is important not only in reaching a diagnosis but also in engaging patients and their families and planning therapeutic interventions. In addition to the basic principles of assessment, specific psychiatric conditions require additional details. Working with children and adolescents, with older individuals, and those with intellectual disabilities brings with it special challenges. It is crucial that clinicians are aware of the cultural context of the individual being assessed and that they take care and spend time to carry out the assessment, which may need to continue over a number of sessions. To achieve optimal results and outcomes, good therapeutic alliance is essential. It is critical that clinicians are aware of the impact of culture on the genesis, perpetuation, and prognosis of symptoms. Clinicians must be even more careful when working with special groups and psychiatric disorders, which are described further in this chapter.

Mental state assessment: Basic principles

10.1093/med/9780198723196.003.0003 ◽

2018 ◽

Author(s):

Dinesh Bhugra ◽

Antonio Ventriglio ◽

Kamaldeep S. Bhui

Keyword(s):

Therapeutic Alliance ◽

Mental State ◽

Health Professionals ◽

Cultural Context ◽

Management Strategies ◽

State Assessment ◽

Idioms Of Distress ◽

Basic Principles ◽

The Core ◽

The Individual

Mental state assessment or examination lies at the core of assessing patients and reaching a diagnosis that can be followed by appropriate and suitable management strategies. It is important that clinicians take enough time to carry out the assessment, which may require several sessions. This is especially true for patients whose cultures may differ from those of the clinician. It is important that assessments are not rushed and that gradual therapeutic alliance is developed so that patients and their carers have confidence in the clinician. Clinicians should take time to understand the cultural context of the individual and the significance of culture in the genesis, perpetuation, and prognosis of illness symptoms. Health professionals need to be aware of cultural idioms of distress and emotional and clinical needs. Even when both the clinician and the patient come from the same culture, a thorough and proper assessment is necessary.

Burden and modifications in life from the perspective of caregivers for patients after stroke

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692012000500017 ◽

2012 ◽

Vol 20 (5) ◽

pp. 944-953 ◽

Cited By ~ 16

Author(s):

Huana Carolina Cândido Morais ◽

Arethusa Morais de Gouveia Soares ◽

Ana Railka de Souza Oliveira ◽

Carolina Maria de Lima Carvalho ◽

Maria Josefina da Silva ◽

...

Keyword(s):

Mental State ◽

Leisure Activities ◽

Care Program ◽

Daily Routine ◽

Life Changes ◽

Cross Sectional ◽

Perceived Burden ◽

Burden Scale ◽

The Impact ◽

OBJECTIVE: to analyze the impact that caring has on a member of the family caring for a patient after a cerebrovascular accident, correlating life modifications and mental suffering with the perceived burden. METHOD: a cross-sectional, quantitative study, undertaken in January-April 2010 in Fortaleza, Ceará, Brazil. RESULT: 61 individuals were investigated, monitored by three hospitals' Home Care Program. Data collection was through interviews for identifying life changes, and through the application of three scales for investigating perceived burden, mental state and mental suffering. Respectively these were the Caregiver Burden Scale (CBS), the Mini-Mental State Examination (MMSE) and the Self Reported Questionnaire (SRQ). The majority of the carers were female, married, and the children of the stroke patients. The average age was 48.2 years (±12.4). The most-cited life modifications referred to the daily routine, to leisure activities, and to exhaustion or tiredness. Regarding burden, the dimensions of General tension, Isolation and Disappointment stood out. It was ascertained that overload was more severe when the carer presented more symptoms of psychological distress, in the absence of a secondary carer, and when the principal carers reported perceiving changes in their bodies and health. CONCLUSION: an association between burden and the carer's mental state was not observed. Understanding the care, through analysis of the burden and of the knowledge of the biopsychosocial situation will provide support for the nurse's work in reducing the overload for family caregivers.

Education does not equally influence all the Mini Mental State Examination subscales and items: inferences from a Brazilian community sample

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462010005000009 ◽

2010 ◽

Vol 32 (3) ◽

pp. 223-230 ◽

Cited By ~ 9

Author(s):

Jerson Laks ◽

Evandro Silva Freire Coutinho ◽

Washington Junger ◽

Heitor Silveira ◽

Raphael Mouta ◽

...

Keyword(s):

Mental State ◽

Community Sample ◽

Community Dwelling ◽

Delayed Recall ◽

Functional Activities ◽

Key Factor ◽

Z Scores ◽

The Impact ◽

OBJECTIVE: Mini-Mental State Examination cutoffs have been presented for schooling levels to screen cognitive impairment. However, items may behave differently with regards to education. The objective of this study was to examine the impact of education on MMSE subscales and items. METHOD: Community-dwelling participants aged 65 years or more (n = 990, females = 637, age = 74.1 years, range 65-108) were stratified as illiterate (n = 373), 1-8 (n = 540), 9-12 (n = 63), and more than 12 years of schooling (n = 14) and were screened with MMSE and Pfeffer Functional Activities Questionnaire. To make the Mini-Mental State Examination items comparable, each item was transformed into z scores. Multiple linear regression was used to estimate the effect of schooling on MMSE subs and items controlling for age, sex, and activities of daily life. RESULTS: Temporal and space orientation, attention/calculation, repetition, reading, writing, and drawing scores improved as education increased, but not memory registration, three step command, and naming. Reading and writing displayed the largest coefficients, whereas education exerted no influence on naming and three step command tasks. CONCLUSION: Education does not exert an important effect on naming, three step command, memory registration, and delayed recall. As memory is a key factor for diagnosing dementia, these items could be considered despite education.

Reduction in Fatigue Symptoms Following the Administration of Nutritional Supplements in Patients with Multiple Sclerosis

Medical Sciences ◽

10.3390/medsci9030052 ◽

2021 ◽

Vol 9 (3) ◽

pp. 52

Author(s):

Pasquale Ferorelli ◽

Francesco Antonelli ◽

Anna Shevchenko ◽

Carlo Mischiati ◽

Manfred Doepp ◽

...

Keyword(s):

Multiple Sclerosis ◽

Dietary Supplements ◽

Nutritional Supplements ◽

Therapeutic Interventions ◽

Inflammatory Parameters ◽

Impact Scale ◽

Fatigue Severity ◽

The Individual ◽

Two Parameters ◽

The Impact

Despite recent advances in immune-modulatory drugs, pharmacological therapies have been proven ineffective in severe presentations of multiple sclerosis (MS), including secondary progressive MS. At present, therapeutic interventions’ performance is primarily focused on ameliorating symptoms to improve the patient’s quality of life (QOL). Among complementary treatments, nutrition has been considered a decisive factor to control symptoms and enhance the wellness of MS patients. Although no special diets are associated with MS, the impact of diet and dietary supplements on the course of progressive forms of the disease has been studied during the last few years. Fatigue is among the most common and disabling symptoms reported by MS patients. Fatigue has been defined in the Multiple Sclerosis Council for Clinical Practice Guidelines (MSCCPG, 1998) as a “subjective lack of physical and/or mental energy that the individual perceives as an interference with habitual and desired activities”. This study aimed to compare the psychometric functioning of the “Fatigue Severity Scale” (FSS) and the “Modified Fatigue Impact Scale” (MFIS) in our sample of people with MS. Specifically, during chronic treatment, the change in these two parameters with two vitamin-rich dietary supplements (Citozym® and Ergozym®) was evaluated. The impact of these nutritional supplements revealed differences in antioxidant and anti-inflammatory parameters among the volunteers in the treatment group, with a subsequent improvement in fatigue. In conclusion, the results obtained have confirmed the effectiveness of complementary nutritional therapies, evaluated essentially based on hematological biomarkers, through which it is possible to act on disability to improve the QOL of MS patients.

Acute Psychogeriatric Inpatient Treatment Improves Neuropsychiatric Symptoms but Impairs the Level of Functioning in Patients with Dementia

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000431087 ◽

2015 ◽

Vol 40 (5-6) ◽

pp. 290-296 ◽

Cited By ~ 4

Author(s):

Hanna-Mari Alanen ◽

Anneli Pitkänen ◽

Kirsti Suontaka-Jamalainen ◽

Olli Kampman ◽

Esa Leinonen

Keyword(s):

Mental State ◽

Daily Living ◽

Neuropsychiatric Symptoms ◽

Functional Decline ◽

Neuropsychiatric Inventory ◽

Behavioral Disturbances ◽

Level Of Functioning ◽

The Impact ◽

Aims: To explore the impact of hospitalization on neuropsychiatric symptoms (NPS) and the level of functioning in patients with dementia. Our aim was also to study the influence of psychotropic medications. Methods: Behavioral disturbances, cognition and functional status of 89 patients were assessed using the Neuropsychiatric Inventory (NPI), Mini-Mental State Examination, Barthel Index, and Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCSADL). Results: The total NPI score decreased from 34.6 to 19.5 (p < 0.001), and ADL decreased from 32.2 to 21.7 (p < 0.001) during the hospital stay (mean of 44 days). For a change in ADL, only the effect of anxiolytics was significant (p = 0.045). For a change in NPI with antipsychotic and anxiolytic doses and Mini-Mental State Examination as covariates, no significant relationship was found. Conclusion: NPS improved significantly during hospitalization, but neither antipsychotic nor anxiolytic medication use explained this improvement. In patients using anxiolytics, the functional decline was substantial. These results do not support anxiolytic use in demented patients with NPS.

OVERVIEW OF COGNITIVE FUNCTION IN THE ELDERLY WITH VARIATIONS OF TOTAL REMAINING TEETH REVIEW FROM MINI-MENTAL STATE EXAMINATION

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v9.i11.2021.4389 ◽

2021 ◽

Vol 9 (11) ◽

pp. 168-181

Author(s):

Ifwandi ◽

Dewi Saputri ◽

Liana Rahmayani ◽

Pocut Aya Sofya ◽

Syahrial ◽

...

Keyword(s):

Cognitive Function ◽

Mental State ◽

Tooth Loss ◽

The Elderly ◽

Research Subjects ◽

Increased Risk ◽

History Of ◽

The Impact ◽

When a person reaches the elderly phase, the function of the body's organs decreases, which causes an increased risk of disease and death. Including dental infections such as caries and periodontal disease which are the main factors for tooth loss. Tooth loss does not only affect the impact of mastication but also affects a person's cognitive function. This condition occurs because when a person loses teeth, the function of the Periodontal Mechanoreceptors decreases, disrupting the function of the hippocampus which is important for memory in the brain. Loss of a large number of teeth tends to indicate low cognitive function, but several factors affect cognitive function, namely education level, Diabetes Mellitus, Hypertension, heart disease, depression, sleep disorders, head injury, physical activity, and a history of smoking. Mini-Mental State Examination (MMSE) is a tool to assess a person's cognitive function. This study aims to see the description of cognitive function in the elderly at the Geunaseh Sayang Nursing Home with variations in the number of tooth losses. This study was conducted with 43 research subjects with interviews and intra-oral examination methods. Based on the results of the study, it can be concluded that the elderly who only have fewer teeth show a higher decline in cognitive function compared to the elderly with more teeth in the oral cavity. This is following the theory which states that the more teeth you lose, the lower your cognitive function will be.

Comparison between the accuracy of Montreal Cognitive Assessment and Mini-Mental State Examination in the detection of mild cognitive impairment

10.21203/rs.3.rs-136185/v1 ◽

2021 ◽

Author(s):

Nayyereh Aminisani ◽

Rasoul alimi ◽

Ali Javadpour ◽

Mohhamad Asghari-Jafarabadi ◽

Mozhgan Jourian ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Mental State ◽

Cognitive Assessment ◽

Screening Tools ◽

Montreal Cognitive Assessment ◽

The Impact ◽

Abstract Introduction:Ageing can cause major changes in the central nervous system of the body, resulting in cognitive decline and associated disorders. Therefore, there is a growing need for an effective cognitive screening method to enhance the diagnosis of mild cognitive impairments and to prevent occurring dementia and Alzheimer's Disease (AD). Our study aimed to compare the accuracy of MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) while evaluating the independent and interaction effects of age and educational level on these screening tools in a healthy sample.Method: The data for the current study was based on the registration phase of the study during 2016-2018 in Neyshabour Longitudinal Study on Ageing (NeLSA). Both the MoCA and MMSE tests were used to assess cognitive decline among 3326 participants aged 50-94 years of old. The ROC curve analysis and the predictive values were performed to evaluate the diagnostic accuracy of MMSE to discriminate Mild Cognitive Impairment (MCI) from the cognitively healthy adult basis of MoCA scores as a gold test. A two-way ANCOVA was run to examine the effect of Age and Education level on MoCA and MMSE score, while controlling for a gender effect. Data were analyzed using MedCalc Statistical Software version 13.0.6 (MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2014). Results: The chi-square test shows that MoCA ((72% and 90%) significantly (p-value<0.001() classified more persons as cognitively impaired than the MMSE (45.1%), respectively; using a cutoff score of 24 on the MMSE, 23 and 26 on the MoCA. The cut-off point of below 25 yielded the highest Youden J index for the MMSE in discrimination between MCI and healthy basis of MOCA<23 with an AUC of 0.9 (95% CI: 0.89-0.91) and MOCA<26 with an AUC of 0.87 (95% CI: 0.86-0.89). A two-way ANCOVA results show that the effect of education variable on the MMSE and MoCA score is more important than the age variable.Discussion: Although the cut-off scores give a clear indication of the sensitivity and specificity, they are unable to monitor the impact of confounders, which increase the risk of incorrect classification. Taken together, these findings demonstrate the use of demographically adjusted MoCA and MMSE scores that could provide clinicians with a more reliable estimation of the severity of cognitive impairment, thus increasing the instrument's clinical usefulness.

Associations between Commonly Used Characteristics in Frailty Assessment and Mental State in Frail Elderly People

Proceedings ◽

10.3390/proceedings2191247 ◽

2018 ◽

Vol 2 (19) ◽

pp. 1247 ◽

Cited By ~ 1

Author(s):

Iván González ◽

Rocío Garrido ◽

Fco Navarro ◽

Jesús Fontecha ◽

Ramón Hervás ◽

...

Keyword(s):

Logistic Regression ◽

Cognitive Decline ◽

Elderly People ◽

Mental State ◽

Multiple Logistic Regression ◽

Frail Elders ◽

Frailty Assessment ◽

The Impact ◽

This paper presents a cross-sectional study to analyze the impact on cognitive decline of a set of characteristics used for frailty assessment in elderly people. Considered characteristics come from several dimensions, including anthropometric, biological, nutritional, functional and mobility. Cognitive functioning is estimated by the Mini-Mental State Examination test. Additionally, mobility dimension is assessed from two perspectives: one based on direct observation of ambulation through subjective gait analyses; and the other performing explicit gait trials by using the instrumentation provided. In order to accomplish the purpose of this research, a multiple logistic regression analysis is carried out. Variables are grouped according to popular and/or standardized categories adopted in other clinical studies. Mini-Mental State Examination represents the dependent variable, while the characteristics for frailty assessment make up the set of explanatory variables. The multiple logistic regression is performed using a sample of 81 frail elders from two nursing homes in Spain. The results obtained indicate that frail elders aged 90 years of older, with moderate dependence in daily functioning, moderate risk of falls and with a stride interval gait variability greater than 6% were most likely to suffer cognitive decline, representing what is called cognitive frails.

Association of SNCA Parkinson's Disease Risk Polymorphisms With Disease Progression in Newly Diagnosed Patients

Frontiers in Neurology ◽

10.3389/fneur.2020.620585 ◽

2021 ◽

Vol 11 ◽

Author(s):

Aleksandra A. Szwedo ◽

Camilla Christina Pedersen ◽

Anastasia Ushakova ◽

Lars Forsgren ◽

Ole-Bjørn Tysnes ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Confidence Interval ◽

Disease Progression ◽

Mental State ◽

Rating Scale ◽

Minor Effect ◽

The Impact ◽

Objectives: To evaluate the impact of SNCA polymorphisms originally identified as risk factors for Parkinson's disease (PD) on the clinical presentation and progression of the disease in a large cohort of population-based patients with incident PD.Methods: Four hundred thirty-three patients and 417 controls from three longitudinal cohorts were included in the study. Disease progression was recorded annually for up to 9 years using the Unified Parkinson's Disease Rating Scale (UPDRS) or Mini-Mental State Examination. Genotypes for five variants within the SNCA locus (rs2870004, rs356182, rs5019538, rs356219, and rs763443) were determined. We studied the association between each variant and disease progression using linear mixed-effects regression models.Results: The clinical profile of the patients with PD at the point of diagnosis was highly uniform between genotype groups. The rs356219-GG genotype was associated with a higher UPDRS II score than A-allele carriers (β = 1.52; 95% confidence interval 0.10–2.95; p = 0.036), but no differences were observed in the rate of progression of the UPDRS II scores. rs356219-GG was also associated with a faster annual change in Mini-Mental State Examination score compared with A-carriers (β = 0.03; 95% confidence interval 0.00–0.06; p = 0.043).Conclusions: We show that the known PD-risk variant rs356219 has a minor effect on modifying disease progression, whereas no differences were associated with rs2870004, rs356182, rs5019538, and rs763443. These findings suggest that SNCA variants associated with PD risk may not be major driving factors to the clinical heterogeneity observed for PD.

PENGARUH AKTIVITAS PENGASUHAN CUCU TERHADAP FUNGSI KOGNITIF PADA PEREMPUAN LANSIA

Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia ◽

10.52386/neurona.v35i3.6 ◽

2018 ◽

Vol 35 (3) ◽

Author(s):

Frederica Jovianti ◽

Linda Suryakusuma ◽

Yuda Turana ◽

Yvonne Suzy Handajani

Keyword(s):

Cognitive Function ◽

Mental State ◽

Social Activity ◽

The Elderly ◽

Cognitive Stimulation ◽

Active Ageing ◽

Neurodegenerative Process ◽

The Impact ◽

THE IMPACT OF GRANDPARENTING ACTIVITY ON COGNITIVE FUNCTION IN ELDERLY WOMANABSTRACT Introduction: Cognitive impairment is a neurodegenerative process which often experienced by the elderly. One of the factors associated with cognitive function is grandparenting which is common and has become a social norm in Indonesia.Aims: To determine the association between characteristics of the subjects and grandparenting activity with cognitive function in elderly woman.Methods: This study was conducted on July 2016–January 2017 in West Jakarta and as a part of Active Ageing Research in Atma Jaya University. The data were collected through grandparenting activity questionnaire and cognitive function assessment using Mini Mental State Examination (MMSE).Results: Based on 93 participants, the age mean was 67,51±5,058 and majority had education <9 years (54,8%). Data analysis showed that education, grandparenting, the quality of grandparenting, types of grandparenting activity specifically preparing food and/or feeding child and storytelling had a significant association with global cognitive function.Discussions: Physical, social activity, and cognitive stimulation while caring for grandchildren can prevent decline in cognitive function.Keywords: Elderly, cognitive function, grandparentingABSTRAK Pendahuluan: Penurunan fungsi kognitif merupakan suatu proses neurodegeneratif yang sering dialami oleh lansia. Salah satu faktor yang dianggap berpengaruh terhadap fungsi kognitif adalah aktivitas pengasuhan cucu yang masih umum dilakukan dan telah menjadi bagian dari norma masyarakat di Indonesia.Tujuan: Mengetahui hubungan antara karakteristik subjek dan aktivitas pengasuhan cucu terhadap fungsi kognitif pada perempuan lansia.Metode: Penelitian dilakukan pada bulan Juli 2016–Januari 2017 di Jakarta Barat dan merupakan bagian dari penelitian Active Ageing di Universitas Atma Jaya. Pengumpulan data dilakukan melalui pengisian kuesioner aktivitas pengasuhan cucu dan pengukuran fungsi kognitif menggunakan Mini Mental State Examination (MMSE).Hasil: Penelitian terhadap 93 subjek dengan rerata usia 67,51±5,058 dan sebagian besar berpendidikan <9 tahun (54,8%). Pendidikan, aktivitas pengasuhan cucu, kualitas pengasuhan cucu, serta jenis aktivitas pengasuhan cucu, yaitu menyiapkan dan/atau menyuapi makanan dan membacakan cerita memiliki hubungan yang bermakna dengan fungsi kognitif global.Diskusi: Aktivitas fisik, sosial dan stimulasi kognitif pada saat mengasuh cucu dapat mencegah terjadinya penurunanfungsi kognitif.Kata kunci: Aktivitas pengasuhan cucu, fungsi kognitif, lanjut usia