LIMITATIONS OF COGNITIVE STATUS EXAMS - A CASE-BASED DISCUSSION

DESPITE their extensive use in psychiatric and medical settings, brief mental status examinations have significant limitations that are easi ly overlooked in the pressure-cooker environments within which they ar e commonly used. Although undoubtedly of value as quick screening devi ces, the sheer brevity of these instruments all but guarantees limited validity. Brief examinations perform best with grossly impaired cases , aler ting clinicians to the fact that something is badly amiss in pa tients who are significantly confused, disoriented, aphasic, or otherw ise severely impaired. Very poor scores are accordingly frequently use ful. Moderate or even perfect scores, however, will frequently be misl eading, because patients with compromised brains often obtain them (Ne lson et al. 1986). One such case follows.