Skip to main content
Journal of Psychiatry & Neuroscience : JPN logoLink to Journal of Psychiatry & Neuroscience : JPN
. 1994 Mar;19(2):103–108.

A clinical evaluation of the Neurobehavioral Cognitive Status Examination in a general psychiatric inpatient population.

C J Lamarre 1, S B Patten 1
PMCID: PMC1188573  PMID: 8204561

Abstract

The Neurobehavioral Cognitive Status Examination (NCSE) is a structured test of cognitive functioning. The NCSE assesses a broader range of cognitive functioning than the Mini-Mental State Examination (MMSE), but remains brief enough to be administered at the bedside in clinical settings. The purpose of this study was to assess the sensitivity, specificity, predictive value and reliability of the NCSE as a clinical case-finding instrument for DSM-III-R defined organic mental disorders in psychiatric inpatients. Validity was assessed by comparing the results of the test (interpreted as "pass" or "fail") to a blind clinical assessment by an experienced psychiatrist. The NCSE was found to have superior sensitivity to the MMSE (83% versus 43%), but inferior specificity (47% versus 97%). The low specificity resulted in a positive predictive value of only 24%. The NCSE had good test-retest reliability (Kappa = .69), but the inter-rater reliability was not as good (Kappa = 0.57). The NCSE was too non-specific to be used as a case-finding instrument for organic mental disorders. In conclusion, although clinicians may find the NCSE to be a valuable instrument for the assessment of cognitive function, it cannot be used as a screening or case-finding instrument for organic disorders among psychiatric inpatients.

Full text

PDF
103

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blessed G., Tomlinson B. E., Roth M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry. 1968 Jul;114(512):797–811. doi: 10.1192/bjp.114.512.797. [DOI] [PubMed] [Google Scholar]
  2. DePaulo J. R., Jr, Folstein M. F. Psychiatric disturbances in neurological patients: detection, recognition, and hospital course. Ann Neurol. 1978 Sep;4(3):225–228. doi: 10.1002/ana.410040306. [DOI] [PubMed] [Google Scholar]
  3. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  4. Hersch E. L. Development and application of the extended scale for dementia. J Am Geriatr Soc. 1979 Aug;27(8):348–354. doi: 10.1111/j.1532-5415.1979.tb06056.x. [DOI] [PubMed] [Google Scholar]
  5. Jacobs J. W., Bernhard M. R., Delgado A., Strain J. J. Screening for organic mental syndromes in the medically ill. Ann Intern Med. 1977 Jan;86(1):40–46. doi: 10.7326/0003-4819-86-1-40. [DOI] [PubMed] [Google Scholar]
  6. KAHN R. L., GOLDFARB A. I., POLLACK M., PECK A. Brief objective measures for the determination of mental status in the aged. Am J Psychiatry. 1960 Oct;117:326–328. doi: 10.1176/ajp.117.4.326. [DOI] [PubMed] [Google Scholar]
  7. Knights E. B., Folstein M. F. Unsuspected emotional and cognitive disturbance in medical patients. Ann Intern Med. 1977 Dec;87(6):723–724. doi: 10.7326/0003-4819-87-6-723. [DOI] [PubMed] [Google Scholar]
  8. Lamarre C. J., Patten S. B. Evaluation of the Modified Mini-Mental State Examination in a general psychiatric population. Can J Psychiatry. 1991 Sep;36(7):507–511. doi: 10.1177/070674379103600708. [DOI] [PubMed] [Google Scholar]
  9. Lau C., Wands K., Merskey H., Boniferro M., Carriere L., Fox H., Hachinski V. C. Sensitivity and specificity of the extended scale for dementia. Arch Neurol. 1988 Aug;45(8):849–852. doi: 10.1001/archneur.1988.00520320035012. [DOI] [PubMed] [Google Scholar]
  10. Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975 Oct;23(10):433–441. doi: 10.1111/j.1532-5415.1975.tb00927.x. [DOI] [PubMed] [Google Scholar]
  11. Schwamm L. H., Van Dyke C., Kiernan R. J., Merrin E. L., Mueller J. The Neurobehavioral Cognitive Status Examination: comparison with the Cognitive Capacity Screening Examination and the Mini-Mental State Examination in a neurosurgical population. Ann Intern Med. 1987 Oct;107(4):486–491. doi: 10.7326/0003-4819-107-4-486. [DOI] [PubMed] [Google Scholar]
  12. WILLIAMSON J., STOKOE I. H., GRAY S., FISHER M., SMITH A., MCGHEE A., STEPHENSON E. OLD PEOPLE AT HOME. THEIR UNREPORTED NEEDS. Lancet. 1964 May 23;1(7343):1117–1120. doi: 10.1016/s0140-6736(64)91803-3. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Psychiatry and Neuroscience are provided here courtesy of Canadian Medical Association

RESOURCES