A CLINICAL-EVALUATION OF THE NEUROBEHAVIORAL COGNITIVE STATUS EXAMINATION IN A GENERAL PSYCHIATRIC INPATIENT POPULATION

The Neurobehavioral Cognitive Status Examination (NCSE) is a structure d test of cognitive functioning. The NCSE assesses a broader range of cognitive functioning than the Mini-Mental State Examination (MMSE), b ut remains brief enough to be administered at the bedside in clinical settings. The purpose of this study was to assess the sensitivity, spe cificity, predictive value and reliability of the NCSE as a clinical c ase-finding instrument for DSM-III-R defined organic mental disorders in psychiatric inpatients. Validity was assessed by comparing the resu lts of the test (interpreted as ''pass'' or ''fail'') to a blind clini cal assessment by an experienced psychiatrist The NCSE was found to ha ve superior sensitivity to the MMSE (83% versus 43%), but inferior spe cificity (47% versus 97%). The low specificity resulted in a positive predictive value of only 24%. The NCSE had good test-retest reliabilit y (Kappa = .69), but the inter-rater reliability was not as good (Kapp a = 0.57). The NCSE was too non-specific to be used as a case-finding instrument for organic mental disorders. In conclusion, although clini cians may find the NCSE to be a valuable instrument for the assessment of cognitive function, it cannot be used as a screening or case-findi ng instrument for organic disorders among psychiatric inpatients.