Rating scales and cognition tests Flashcards
Standard screening assessment for dementia developed in 1976 by Folstein
MMSE
Number of points on an MMSE
30
Years of formal education at which the cut-off for abnormal MMSE is reduced
9
Normal cut-off for an MMSE
23-24
Issues the MMSE is insensitive to
Early decline
Change
Types of tasks in the MMSE
Orientation Registration and recall Attention Multistep command Naming Repetition language Reading comprehension Writing Visual construction
Abilities tested in a clock drawing task
Verbal comprehension
Short term working memory
Spatial awareness
Executive function
Points given in the 7 scores screening method for clock drawing
The clock is divided into four quadrants
In the first three quadrants if any errors are present a score of 1 is given
In the fourth quadrant if any errors are present a score of 4 is given
Maximum score is 7
Six cognitive domains tested in the ACE
Orientation Attention Memory Verbal fluency Language Visuospatial ability
Cut-off for an intermediate ACE score
88
Cut-off for an abnormal ACE score
82
Sensitivity for an ACE score of 88
1.00
Specificity for an ACE score of 88
0.96
Sensitivity for an ACE score of 82
0.93
Specificity for an ACE score of 82
1.00
Tests for parietal lobe function
Stereognosis
Finger agnosia
Right left orientation
Two point discrimination
The ability to perceive the form of an object by touch in the absence of other sensory information
Stereognosis
Cognitive domain tested by serial sevens
Concentration
Cognitive domain tested by the intersecting polygons test
Constructional praxis
Most helpful orientation test
Time
Part of orientation not known by many people without memory issues
Exact date
All-purpose screening tool used in epidemiological studies, developed by Goldberg
General health questionnaire
Number of items in the most widely used general health questionnaire
28
Total possible score on a 28 item general health questionnaire
84
Clinician administered interview schedule used in the National Psychiatric Morbidity Surveys of Great Britain, aims to identify common psychiatric disorders and focuses on neurotic conditions
Clinical Interview Schedule
Exists as both a 58 item self-report version and a 25 item objective version; measures neurotic symptoms in outpatient groups
Hopkins Symptom Check List
Developed by Spitzer on the basis of the DSM III. Self-report scale that aims to diagnose common neurotic conditions in primary care.
Patient Health Questionnaire
Derivative of the patient health questionnaire that focuses on the 9 depression criteria in DSM IV
PHQ-9
Derivative of the patient health questionnaire that focuses on symptoms of anxiety
GAD-7
Derivative of the patient health questionnaire that focuses on symptoms of depression including somatic symptoms
PHQ-15
Cut-offs in the PHQ-9
0-4 normal 5-9 mild depression 10-14 moderate depression 15-19 moderately severe depression 20-27 severe depression
Clinician administered semi-structured interview that generates clinical diagnoses along the ICD framework
Present state examination
Developed by Wing, has replaced the PSE. Semi-structured interview that focuses on adult psychopathology
Schedule for assessment in neuropsychiatry
Semi-structured clinical interview used to diagnose patients where the is a psychiatric diagnosis suspected. In line with DSM criteria. Arguably the most reliable instrument for psychiatric diagnoses.
Structured clinical interview for DSM-IV
Questions asked in the two question scale for depression
- Over the past two weeks, have you ever felt down, depressed, or hopeless
- Have you felt little interest or pleasure in doing things?
Number of items in the Hamilton depression rating scale
17-21
Focus of the Hamilton depression rating scale
Physical symptoms
Severity of depression (not a screening tool)
Number of items in the Montgomery-Asberg depression rating scale
10
Focus of the MADRS
Sensitive to change
Specific clinical use for the MADRS
Before and after ECT to monitor change
Number of items in the Beck depression inventory
21
Maximum score on the Beck depression inventory
63
Self-rated depression scales
Beck's depression inventory Zung depression inventory Geriatric depression scale Hospital anxiety depression scale Edinburgh postnatal major depression scale
Observer rated/clinician administered depression scales
Hamilton depression rating scale
MADRS
Cornell scale for depression in dementia
Cut-offs for Beck depression inventory
0-13 normal
14-19 mild
20-28 moderate
>28 severe
Disadvantage of Beck depression inventory
Lacks discrimination among the very ill
Focus of Beck depression inventory
Psychological rather than somatic features
Number of items in Zung depression inventory
20
Minimum and maximum scores on Zung depression inventory
25-100
Advantage to Zung depression inventory
Lacks bias towards psychological symptoms seen in Beck depression inventory
Disadvantages to Zung depression inventory
Poor correlation with observer rating
Insensitive to change
Depression scale where the patient places their state of mind along a 10cm line
Visual analogue scale
Minimum age the Beck depression inventory can be used for
14
Age range for the Reynolds child depression scale
8-12
Age range for the Reynolds adolescent depression scale
13-18
Depression scale specifically developed for post-natal depression
Edinburgh post-natal depression scale
Number of items in the Edinburgh postnatal depression scale
10
Depression scale specifically designed for use in the older adult population
Geriatric depression scale
Differences in the geriatric depression scale compared to other similar scales
Fewer somatic questions
Only requires yes or no answers
Only looks at the past week
Depression scale specifically designed for use by patients with dementia
Cornell scale for depression in dementia
Person who answers questions in the Cornell scale for depression in dementia
The patient’s primary caregiver
Depression scale specifically designed for use in a hospital ward with the aim to avoid patients’ answers being overheard
Brief assessment schedule depression cards
Way of answering the brief assessment schedule depression cards questions
Choosing answers from a deck of cards
Depression scale specifically designed for patients with schizophrenia
Calgary depression scale for schizophrenia
Questions on CAGE alcohol questionnaire
- Have you ever felt like cutting down on your drinking?
- Have people annoyed or criticised you for drinking?
- Have you ever felt guilty about your drinking?
- Have you ever had a drink first thing in the morning as an eye opener?
Score in CAGE questionnaire highly suggestive of problem drinking
2
Number of items in the AUDIT alcohol questionnaire
10
Score in AUDIT alcohol questionnaire suggestive of harmful drinking
8
Score in AUDIT questionnaire indicative of alcohol dependency
13 in women
15 in men
Number of items in the Michigan alcohol screening test
25
Score on MAST alcohol questionnaire highly suggestive of problem drinking
6
Alcohol questionnaire which includes a specific variant for older people
MAST
Scores used by clinicians to rate the severity of alcohol withdrawal in a patient
CIWA
GMAWS
SAWS
Total possible score on CIWA
67
Symptoms covered on CIWA
Nausea Tremor Sweating Anxiety Agitation Hallucinations Headache Orientation
Scale used to measure aggression and conduct problems in children aged 7-17
The child and adolescent functional assessment scale
Scale completed by clinical staff used to measure aggression and conduct problems in children aged 7-17
The child and adolescent functional assessment scale
Checklist completed by parents or other adults who know a child well which measures behaviour in children aged 4-16
The child behaviour checklist
Number of items in the child behaviour checklist
113
Three different scores given in the child behaviour checklist
Total score
Internalising behaviours score
Externalising behaviours score
Examples of internalising behaviours in the child behaviour checklist
Fearful
Shy
Anxious
Inhibited
Examples of externalising behaviours in the child behaviour checklist
Aggressive
Antisocial
Under controlled
Age ranges for the two versions of the child behaviour checklist
1.5-5
6-18
Schedule designed for children as a fully structured interview to make DSM diagnoses
Diagnostic interview schedule for children
Rating scales used to measure child psychopathology, most often used in ADHD diagnoses
Conners rating scales
Schedule used to measure a variety of psychopathologies in older adults
Geriatric mental state schedule
Area of deficiency the MMSE is poor at picking up
Frontal lobe
Number of points in the AMT
10
Questions in the AMT
Age Time Address which is learned and recalled at the end of the test Year Current location Identification of two people e.g. nurse, doctor DOB Year of the end of WWI Name of Monarch Count backwards from 20
Normal cut-off for an abnormal AMT
7/8
Cognitive test which is the gold standard for measuring change in cognitive function in trials of anti-dementia drugs
Alzheimer’s disease assessment scale
Scales looking at behavioural changes in patients with Alzheimer’s disease
BEHAVE-AD
Neuropsychiatric inventory
MOUSEPAD
Scale intended to assess the level of disability and level of care required for an elderly patient
Clifton assessment procedure for the elderly
Four domains measured in the Clifton assessment procedure for the elderly
Physical disability
Apathy
Communication difficulties
Social disturbance
Care-giver rated scale looking at activities of daily living in patients with dementia
Bristol activities of daily living scale
Scale looking at positive and negative symptoms in patients with schizophrenia
Positive and negative symptoms scale
Number of items in the PANSS
30
Scale looking at severity of symptoms in patients with diagnosed OCD
Yale-Brown obsessive compulsive scale
Questions in the SCOFF questionnaire for eating disorders
- Do you ever make yourself sick when you are uncomfortably full?
- Do you worry you have lost control over how much you eat?
- Have you recently lost more than 14 pounds in 3 months?
- Do you believe you are fat when others say you are thin?
- Would you say food dominates your life?
Number of positive answers to be significant in SCOFF questionnaire
2
Semi-structured interview which produces ICD-10 personality disorder diagnoses
International personality disorder examination
Scale used for the clinical global improvement scale
1-7
Two domains covered in the clinical global improvement scale
Current severity
Improvement
Number of items in the brief psychiatric rating scale
18-24
Maximum number of points in the brief psychiatric rating scale
108
Five factors measured in the brief psychiatric rating scale
Hostility-suspiciousness Withdrawal-retardation Thinking disturbance Depression-anxiety Activation
Number of items in the scale for assessment of positive symptoms used in patients with schizophrenia
34
Domains covered in the scale for assessment of positive symptoms
Hallucinations
Delusions
Bizarre behaviour
Formal thought disorder
Number of items in the scale for assessment of negative symptoms used in patients with schizophrenia
25
Domains covered in the scale for assessment of negative symptoms
Affective flattening Alogia Apathy Asociality Inattention
Self-reported scale assessing the 12 personality disorders covered in DSM IV
Personality diagnostic questionnaire 4+
Projective personality tests
Rorschach inkblot
Thematic apperception test
Draw-a-person test
Sentence completion tests
Objective personality tests
Minnesota multiphasic personality inventory
Sixteen personality factor questionnaire
NEO personality inventory
Esyenck personality test