One hundred and ninety-two Canadian psychiatry residents (43% of the total Canadian resident population) completed a questionnaire concerning their training in and use of the mental status examination (MSE). Residents perceive a number of deficiencies in their training for the mental status examination. They employ a wide variation in tests, and show a lack of sophistication in how to test for special dysfunctions.
We discuss these data in the context of accumulated research on MSE. It should be possible to provide more systematic training in the MSE and we suggest modifications in resident training which might produce a more uniform and reliable MSE.
References
1.
FolsteinM.F., FolsteinS.E., McHughP.R.“Mini mental state”, a practical method of grading the cognitive state of patients for the clinician.J Psychiatr Res1975; 12: 189–98.
2.
SlettenI.W., ErnhartC.B., UlettG.A.The Missouri automated mental status examination: development, use and reliability.Compr Psychiatry1970; 11(4): 315–27.
3.
WithersE., HintonJ.Three forms of the clinical tests of the sensorium and their reliability.Br J Psychiatry1971; 119: 1–8.
4.
TaylorM.A., AbramsR., FaberR., AlmyG.Cognitive tasks in the mental status examination.J Nerv Ment Dis1980; 168(3): 167–70.
5.
WeitzelW.D., MorganD.W., GuydenT.E., RobinsonJ.A.Toward a more efficient mental status examination.Arch Gen Psychiatry1973; 28: 215–18.
6.
SpitzerR.L., FleissJ.L., BurdockE.I., HardestyA.S.The mental status schedule: rationale, reliability and validity.Compr Psychiatry1964; 5(6): 384–95.
7.
SpitzerR.L., FleissJ.L., EndicottJ., CohenJ.Mental status schedule. Properties of factor-analytically derived scales.Arch Gen Psychiatry1967; 16: 479–93.
8.
CarpenterW.T., SacksM.H., StraussJ.H., BartkoJ.J., RaynerJ.Evaluating signs and symptoms: comparison of structured interview and clinical approaches.Br J Psychiatry1976; 128: 397–403.
9.
WingJ.K., BirleyJ.L.T., CooperJ.E., GrahamP., IsaacsA.D.Reliability of a procedure for measuring and classifying “present psychiatric state”.Br J Psychiatry1967; 113: 499–515.
10.
LuriaR.E., McHughP.R.Reliability and clinical utility of the “Wing” present state examination.Arch Gen Psychiatry1974; 30: 866–71.
11.
CooperJ.E., CopelandJ.R.M., BrownG.W., HarrisT., GourlayA.J.Further studies on interviewer training and inter-rated reliability of the present state examination (PSE).Psychol Med1977; 7: 517–23.
12.
LuriaR.E., BerryR.Teaching the present state examination in America.Am J Psychiatry1980; 137(1): 26–31.
13.
HelzerJ.The use of a structured diagnostic interview for routine psychiatric evaluations.J Nerv Ment Dis1981; 169(1): 45–9.
14.
RappM.S.Re-examination of the clinical mental status examination.Can J Psychiatry1979; 24: 773–5.
15.
TileyD.H., HoffmanJ.A.Mental status examination: myth or method.Compr Psychiatry1981; 22(6): 562–4.
16.
SnyderB.D.An efficient approach to the mental status examination.Minn Medicine1979; 62(12): 901–5.
17.
BellR., HallR.C.W.The mental status examination.Am Fam Practitioner1977; 16(5): 145–52.
18.
FalconerC., LeichnerP.The “beginning psychiatry training syndrome” among psychiatric residents in Canada (submitted).
