So, apparently it’s pretty common for psychiatric professionals to do some sort of cognition test when doing an intake on a new patient. I went in with what turned out to be panic attacks, in spring 1997. Ten years later, I still remember the three words I was asked to memorize:
Sun
Saturn
Basketball
I think they also had me count by 7. Of course I couldn’t remember the counselor’s name, but I’m always bad with that.
Anyone else?
When I was training to do intake interviews, the example words given were:
Pencil
Car
Watch
Most of the class adopted those words, and now, years later, I still use Pencil, Car, Watch for my test of recent memory.
The other test is called “Serial 7’s” You count backwards by 7’s to test mental function.
Sgt Schwartz
I figured he made all of mine spherical to confuse me!
When I used to do first aid at sporting events and was a trainer for sports teams, that was one of the tests we’d administer when someone might have a concussion.
Of course, it didn’t work so well for a few of the guys on a football team that I was a trainer for. There were several guys who’d have great difficulty counting backwards from 100 by 7’s, regardless of whether they had a concussion or not. 
I’m a stone-cold sober college graduate and I couldn’t count backwards by sevens right now if you held a gun to his head.
There was an alternative test we would give for those who were not so mathmatical:
Spell the word “world” backward.
I often used that for people who would have difficulty on the serial 7’s. We could also use serial 3’s if the person could not do sevens. I was all about making mental health more user friendly. 
Sgt Schwartz
That should be “my head”, of course. I really don’t care about “his” head, because I don’t know who “he” is, and therefore threats to “him” are not likely to motivate me, mathematically speaking.
I go now.
I was given a neurological exam when I was being treated for migraines a few years ago. My words were chocolate, basketball and newspaper. I was also given the serial 7s task and my reflexes were tested as well. Good times.
And I still get migraines.
Apple, penny, table.
The complete short exam is called the Mini-Mental Status Exam. It’s a screen for gross cognitive abnormalities.
I can’t believe you remember the three words!
I also never had that kind of intake for regular counseling.
Though I did have an assessment done in 2002 when I was admitted to the hospital. I don’t remember my three words, but I distinctly remember the horror I felt being asked to subtract 7 from 100 and then 7 from the resulting number, etc. I’m so bad with math.
Then the questions about ''Who’s President Right now?"
:rolleyes: ‘‘Bush.’’
''And who was president before that?"
‘‘Clinton.’’
''And who was President Before that?"
embarrassed silence
‘‘Who was President before Clinton?’’
‘‘Um. Ronald Reagan?’’
amused smirks
:mad: ''Look, I was 9, okay?"
Obviously I was just a little confused, being under all that stress and all. Obviously it had nothing to do with a very poor knowledge of contemporary U.S. history… Just stress.
Mr.stretch did one of these mini tests a couple of months ago. He missed 4 out of 14 questions and his doctor was being generous by giving him partial credit on a couple*.
His three words: ball, tree, flag. He could only remember 2 of them. He also had to spell world backwords, which took an incredibly long time when he forgot the “word” for the letter “o,” and he blew counting backwards from 7 because he got the second one wrong and it went downhill from there.
I was there for the test because the doctor and I are trying to get his medication stablized and the testing was kind of a last minute decision based on symptom reporting. It’s really hard to watch someone take that kind of test and struggle with each question.
We are still trying to figure out for sure what the hell happened to my husband’s cognitive abilities.
*he’s not good with streets and addresses so he couldn’t tell her a nearby street and he couldn’t tell her what floor her office was on.
This reminds me of my brother who came out of sedation after his heart attack and at one point was talking about how he was in the hospital, which one, etc., but then when the doc asked him where he was he said the neighborhood, and the floor of his apt building. They were concerned and thought maybe he had been psychotic before the heart thing, but no, just depressed. And he went back to being just depressed after everything settled down.
In the meantime, though, it was faintly amusing* to see him altered. He thought they were going to tie him to his bed, leave, and set the ward on fire. :eek: His plan was to have me pour the pee from his urinal into the HVAC system to create a diversion while he dived into the nearby river and escaped through some underwater pipes. Of course, he was on the 15th floor of the hospital.
He’s still bemused by the details that gradually come out, since he doesn’t remember most of it.
*kind of a laugh to keep from being overhwelmed thing
It’s for seeing if you fell off a ladder, or ate a toxin, or are having cogbitive problems–it’s a triage tool. For a regular counseling intake, I’d know from 10 minutes’ conversation whether your cognition was grossly intact, but I’d also know that you were able to fill out my intake forms, respond to my HIPAA documents, etc.
Um, I’m not so sure I could spell words backwards either. Count by 7’s? Not a chance either. I can do two’s or five’s, but 7’s? I’d be nuts by the end for sure.
Note that getting a few items wrong on the MMSE isn’t a problem; like all exams, it’s a pattern of problems that matters.
Indeed. Mr.stretch was diagnosed bi-polar last year and is being medicated for that. However, he has all these cognitive problems that don’t seem related to the bi-polar, and there are motor skill things that are not neurological. Now that we’ve ruled out neurological problems, we can do more medication adjusting to see if we can reduce the shakes and listing as he walks, as well as trying to figure out if changing meds will help with his cognitive problems.
It seems that he may be more sensitive to the meds due to the interferon treatment he went through–which also might have brought on his major psychotic break. We’re down to researching “chemo brain” and thinking he may have to go off some of his meds. Things are…interesting…at my house!
Oh, man, that does sound complex. Has his sleep been affected at all? (I’m getting at the question of apnea–>functional cognitive decline and delusions.) If so, has it been evaluated?
Yes, he has sleep problems–major sleep problems. He has been through a sleep study and he doesn’t have apnea. But he does wake up on the order of 17 times an hour. Basically, if he isn’t drugged he doesn’t really goes to sleep. His brain doesn’t stop ticking unless it is stopped by artificial means. He takes a number of meds to balance out his bi-polar, anxiety, insomnia, and the leg pain that he’s had since he began the interferon treatment. He’s seeing both a psychiatrist and a psychologist, as well as specialists for other testing–like the neurologist. As we get one thing kinda-sorta figured out, we start working on another.
He has a major evaluation for SSA. The psychologist, who has a reputation locally for being an extremely hard sell, reported back that mr.stretch has bi-polar combined with severe memory loss and cognitive function failure, and that he didn’t think mr.stretch was malingering. Mr.stretch is on a two-year humor-the-wife agreement; he goes to any doctor I want during this two years without being an ass. This is after months of arguing about seeing his mental health practioners.
It’s a difficult situation, but he’s a great guy, so it’s worth it.
Wow. Best of luck to the two of you. That’s a lot of docs.
I don’t remember three words—just all the briefings and pamphlets on patient’s rights, signing in my wallet contents to the front desk, etc.
This went over real well with me, since I was suffering from a major depressive episode, it was like 3 a.m., and I hadn’t slept well for a few days.
Mt. Diablo medical center…you’d think I’d at least have some nice horror stories to come out with from a mental hospital with a name like that. Nuh-uh. Nice staff, modern facilities, I think all of the other patients were suffering from depression or anxiety disorders…most boring goddamn time of my life. Luckily I was depressed, so I could catch up on my sleep, but otherwise it was like spending the weekend in a real-estate office lobby. 