Psych Examations/Questionnaires

Question 1

MMSE interpretation

Answer 1

24 or above = normal (/30)
Cognitive impairment:
mild: 18-23 (some supervision/support)
Mod: 10-17 (clear impairment, ?24h supervision)
Sev: 0-9 (marked, likely 24hr supervision, assistance w/ADL)
Scores are raw and can be corrected for educational achievement and age
NB. pts w/depression say I dunno, dementia will attempt answer

Question 2

MOCA interpretation

Answer 2

Domains tested: visuospatial and exec function, animal naming, attention, language, abstraction, delayed recall, orientation, education level (1 point added if <12y formal edu)
Max: 30
normal: 26 or more
NOT differentiation between mild/mod/severe
If <26 consider referral for further assessment

Question 3

PHQ-9 interpretation

Answer 3

Ask over last 2 wks how often have you been bothered by: 9 items scored 0-3
Inc. self harm thoughts
0-4: none
5-9: mild
10-14: mod
15-19 modly sev
20-27 sev

Question 4

Hospital anxiety and depression

Answer 4

Consider 14 questions: 7+7
Focus on the last week
Each item scored 0-3
Produces a score out of 21 (both anxiety and depression)
Interpretation:
0-7: normal
8-10: borderline
11-14: anxiety/depression

Question 5

GAD-7

Answer 5

7 Sx and their frequency (each max of 3 points)
Focus on last 2 wks
Interpretation:
mild: 5-10
mod: 10-15
sev: 15+
max = 21

Question 6

Alcohol questionnaires

Answer 6

CAGE screening tool
Alcohol Use Disorders Identification Test (AUDIT) screening
Clinical Institute Withdrawal Assessment for Alcohol