Psychiatry

      DSM-IV

        DSM-IV Criteria DSM-IV Codes DSM IV TR DSM-IV Quiz

      Dementia

        Dementia DDx
        Folstein MMSE form Folstein MMSE calculator

        MMSE

        Question Correct Answer Incorrect Answer
        1. What year is it?
        2. What season are we in?
        3. What month are we in?
        4. What is todays date?
        5. What day of the week is it?
        6. What country are we in?
        7. What province are we in?
        8. What city are we in?
        9. What street are we on (What building? if in hospital or clinic)
        10. What is the street number? (What floor? - if in hospital or clinic)
        Name three objects ("Ball", "Car", "Man"). Take a second to pronounce each word. Then ask the patient to repeat all 3 words. Take into account only correct answers given on the first try. Repeat these steps until the subject learns all the words.
        11. Ball?
        12. Car?
        13. Man?
        Either "please spell the word WORLD and now spell it backwards" or "Please count from 100 by substracting 7 every time".
        14. "D" or 93
        15. "L" or 86
        16. "R" or 79
        17. "O" or 72
        18. "W" or 65
        What were the 3 words I asked you to remember earlier?
        19. Ball?
        20. Car?
        21. Man?
        Show the subject a pen and ask:
        22. Could you please name this object?
        Show the subject your watch and ask:
        23. Could you please name this object?
        Listen and repeat after me: 
        24. "No ifs, ands or buts."
        Put a sheet of paper on the desk and show it while saying: "Listen carefully and do as I say."
        25. Take the sheet with your left/right (opposite to dominant)hand.
        26. Fold it in half.
        27. Put it on the floor.
        Show the patient written instructions directing him/her to "CLOSE YOUR EYES" and say:
        28. Do what is written on this page.
        Give the subject a blank sheet and a pen and ask: 
        29. Write a sentence, whatever you want, but a complete sentence. 
        Give the patient the geometric design page and ask:
        30. Could you please copy this drawing?

        SCORE:

        Mild cognitive impairment (MCI)

          American Academy of Neurology (AAN):
          • an individual’s report of his or her own memory problems, preferably confirmed by another person
          • measurable, greater-than-normal memory impairment detected with standard memory assessment tests
          • normal general thinking and reasoning skills
          • ability to perform normal daily activities

          Montreal Cognitive Assessment (MoCA)
          MoCA instructions

      Depression

        "STEAM PIGS"
          Sleep decreased (Insomnia with 2-4 am awakening)
          Thought / concentration difficulties
          Energy decreased
          Appetite disturbance
          Mood depressed

          Psychomotor retardation/agitation
          Interests decreased (anhedonia)
          Guilt, hopelessness, or worthlessness
          Suicidal thoughts / plans / attempts

        Criterion: 5/9 x 2 weeks.