Academic journal article Current Psychiatry

Mnemonics in a Mnutshell: 32 Aids to Psychiatric Diagnosis; Clever, Irreverent, or Amusing, a Mnemonic You Remember Is a Lifelong Learning Tool

Academic journal article Current Psychiatry

Mnemonics in a Mnutshell: 32 Aids to Psychiatric Diagnosis; Clever, Irreverent, or Amusing, a Mnemonic You Remember Is a Lifelong Learning Tool

Article excerpt

From SIG: E CAPS to CAGE and WWHHHHIMPS, mnemonics help practitioners and trainees recall important lists (such as criteria for depression, screening questions for alcoholism, or life-threatening causes of delirium, respectively). Mnemonics' efficacy rests on the principle that grouped information is easier to remember than individual points of data.

Not everyone loves mnemonics, but recollecting diagnostic criteria is useful in clinical practice and research, on board examinations, and for insurance reimbursement. Thus, tools that assist in recalling diagnostic criteria have a role in psychiatric practice and teaching.

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In this article, we present 32 mnemonics to help clinicians diagnose:

* affective disorders (Box 1, page 28) (1), (2)

* anxiety disorders (Box 2, page 29) (3-6)

* medication adverse effects (Box 3, page 29) (7), (8)

* personality disorders (Box 4, page 30) (9-11)

* addiction disorders (Box 5, page 32) (12), (13)

* causes of delirium (Box 6, page 32). (14)

We also discuss how mnemonics improve one's memory, based on the principles of learning theory.

How mnemonics work

A mnemonic--from the Greek word "mnemonikos" ("of memory")--links new data with previously learned information. Mnemonics assist in learning by reducing the amount of information ("cognitive load") that needs to be stored for long-term processing and retrieval. (15)

Memory, defined as the "persistence of learning in a state that can be revealed at a later time," (16) can be divided into 2 types:

* declarative (a conscious recollection of facts, such as remembering a relative's birthday)

* procedural (skills-based learning, such as riding a bicycle).

Declarative memory has a conscious component and may be mediated by the medial temporal lobe and cortical association structures. Procedural memory has less of a conscious component; it may involve the basal ganglia, cerebellum, and a variety of cortical sensory-perceptive regions. (17)

Declarative memory can be subdivided into working memory and long-term memory.

With working memory, new items of information are held briefly so that encoding and eventual storage can take place.

Working memory guides decisionmaking and future planning and is intricately related to attention. (18-21) Functional MRI and positron emission tomography as well as neurocognitive testing have shown that working memory tasks activate the prefrontal cortex and brain regions specific to language and visuospatial memory.

The hippocampus is thought to rapidly absorb new information, and this data is consolidated and permanently stored via the prefrontal cortex. (22-26) Given the hippo-campus' limited storage capacity, new information (such as what you ate for breakfast 3 weeks ago) will disappear if it is not repeated regularly. (17)

Long-term memory, on the other hand, is encoded knowledge that is linked to facts learned in the past; it is consolidated in the brain and can be readily retrieved. Neuroimaging studies have demonstrated opposing patterns of activation in the hippocampus and prefrontal cortex, depending on whether the memory being recalled is:

* new (high hippocampal activity, low prefrontal cortex activity)

* old (low hippocampal activity, high prefrontal cortex activity). (27)

Mnemonics are thought to affect working memory by reducing the introduced cognitive load and increasing the efficiency of memory acquisition and encoding. They reduce cognitive load by grouping objects into a single verbal or visual cue that can be introduced into working memory. Learning is optimized when the load on working memory is minimized, enabling long-term memory to be facilitated. (28)

Mnemonics may use rhyme, music, or visual cues to enhance memory. Most mnemonics used in medical practice and education are word-based, including:

* Acronyms--words, each letter of which stands for a particular piece of information to be recalled (such as RICE for treatment of a sprained joint: rest, ice, compression, elevation). …

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