Summary of Cognitive Function Assessment in Psychiatry (Bedside Clinical Cognitive Function Assessment)

Summary of "Cognitive Function Assessment in Psychiatry"

The video discusses the importance of assessing cognitive function in a clinical setting, particularly in Psychiatry. Cognitive functioning encompasses various mental abilities, including consciousness, attention, Memory, Intelligence, judgment, and insight. Bedside assessments can identify moderate to severe Cognitive Dysfunction but are less effective for milder deficits, which may require structured Neuropsychological Assessments. A comprehensive assessment should consider the patient's overall clinical picture, including history and observations.

Key Components of Cognitive Assessment:

• Consciousness:
  • Assess if the patient is awake, aware, and responsive to stimuli.
  • Document the patient's alertness (e.g., alert, drowsy).
• Orientation:
  • Evaluate orientation to time, place, and person.
  • Questions include:
    • What time of day is it?
    • Where are you?
    • Can you identify yourself and others?
• Attention and Concentration:
  • Attention: Ability to focus on a task.
  • Concentration: Sustained attention over time.
  • Assessment methods include:
    • Digit span test (forward and backward).
    • Serial subtraction tasks (e.g., subtracting numbers).
    • For illiterate patients, use naming tasks (days of the week, months).
• Memory:
  • Types of Memory assessed:
    • Immediate Memory (e.g., digit span).
    • Recent Memory (e.g., three-word recall after distraction).
    • Remote Memory (e.g., personal history or general knowledge).
  • Corroboration from family members may be necessary.
• Intelligence:
  • Assessed through:
    • General knowledge questions (e.g., naming rivers, freedom fighters).
    • Comprehension tasks (e.g., hypothetical scenarios).
    • Arithmetic problems (simple calculations).
    • Abstraction (differences, similarities, and proverbs).
• Judgment:
  • Decision-making capability evaluated through:
    • Personal judgment (future plans).
    • Social judgment (behavioral assessments).
    • Test scenarios (e.g., what to do in emergencies).
• Insight:
  • Awareness of illness and treatment acceptance.
  • Insight is graded from complete denial to true emotional insight.

Methodology:

Conduct a comprehensive assessment including:

• Observation of the patient.
• Review of medical history and clinical findings.
• Engage the patient in a structured interview covering all cognitive domains.

Speakers:

• Dr. Suresh Padamud, Officer of Psychiatry at the Adapt Telemedicine Center, Forensic Psychiatry Unit, Nemanaz, Bangalore.

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Educational

Video