Mini Mental State Examination (MMSE) in First Episode of Psychosis

Article excerpt

Objective: Neurocognitive deficits are now recognized as part of the fundamental disturbances and are a major determinant of functional outcome in psychosis. A cross-sectional association between cognitive deficits and poor social and occupational outcomes has been demonstrated; and treatment of cognitive impairment at the time of the first episode may have the potential to change functional outcomes of the illness. We conducted this study to evaluate cognitive function in first episode of psychosis by the Mini Mental State Examination (MMSE.)

Method: Sixty two patients with first episode of psychosis were selected and underwent psychiatric interview and took MMSE test. Statistical analysis was done using SPSS-18 software.

Results: According to MMSE scale, 47 patients (75.8%) showed definite cognitive impairment, 8(12.9%) showed possible impairment ,and 7(11.3%) showed no cognitive impairment. According to MMSE subscale, registration (69.4%) and recall (77.3%) were the most impaired cognitive areas .

Conclusions: The results of the current study indicate significant cognitive impairment in patients with first episode of psychosis. We recommend future studies with larger sample size and control group for further evaluation of cognitive function as early treatment of cognitive impairments may have important implications in the course of illness.

Keywords: Cognition, Neurobehavioral manifestation, Psychotic disorders

Neurocognitive deficits are now recognized as part of the fundamental disturbances in schizophrenia (1, 2). Patients with schizophrenia have widespread, multifaceted impairments in many domains of cognitive functioning, including executive function, concentration, perceptual/motor processing, vigilance, verbal learning and memory, verbal and spatial working memory, and semantic memory (3-6).

Cognitive deficits may represent a core pathophysiological feature of the illness because at the time of the first psychotic episode these impairments are very similar in profile and severity to those seen in patients with more chronic illness (6). These deficits are apparently present even before the onset of the first psychotic features of the illness (7) and appear to worsen slightly as illness onset approaches (8). A cross-sectional association between cognitive deficits and poor social and occupational outcomes has been demonstrated (9). In patients with an established illness, the correlation between cognitive and functional impairments is consistent across wide

variations in the severity of lifetime functional impairment. (10)

The Mini-Mental State Examination (MMSE), first introduced by Folstein and colleagues in 1975, has become a standard tool for cognitive assessment in the clinical setting. The MMSE facilitates the detection of mental status changes, particularly in the elderly, and thereby enhances patient care (11). As a research tool, it has been used to screen cognitive disorders in epidemiologic studies of community dwelling and institutionalized populations. (12-16). The Farsi version of MMSE (F-MMSE) was validated by Seyedian and his colleagues (17). The aim of this article is to evaluate the cognitive function in patients with first episode of psychosis by use of the MMSE.

Materials and Method

This Our study was aimed to assess the cognitive function in patients with first episode of psychosis by the use of MMSE. Seventy nine patients meeting screening criteria for a first psychotic episode completed a diagnostic Structured Clinical Interview for DSM-IV-TR with the help of a clinical researcher from January 2009 to March 2010 in psychiatric clinics of Kermanshah University of medical sciences. Exclusion criteria of the study were psychotic disorder due to general medical condition, mental retardation, organic cognitive disorders and taking drugs that could affect cognitive status. Of the subjects, 17 were excluded from the study based on the exclusion criteria. …