help with acute cognitive changes in primary mania or psychosis.

[hebel]

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I was hoping for some clarification with expected acute cognitive changes in mania or psychosis from a primary psychiatric condition.

A common rule of thumb I hear a lot is that you shouldn't see much of a cognitive change from these conditions (e.g. MOCA or MMSE is normal or with only mild deficit), so if there is a moderate or severe deficit then you can safely assume its likely delirium.

If this correct? Or is it really just the fluctuating attention or disorientation that would characterize delirium from primary psychosis/mania and acute cognitive worsening should be expected during an acute episode.

 

[Stagg737]

I was hoping for some clarification with expected acute cognitive changes in mania or psychosis from a primary psychiatric condition.

A common rule of thumb I hear a lot is that you shouldn't see much of a cognitive change from these conditions (e.g. MOCA or MMSE is normal or with only mild deficit), so if there is a moderate or severe deficit then you can safely assume its likely delirium.

If this correct? Or is it really just the fluctuating attention or disorientation that would characterize delirium from primary psychosis/mania and acute cognitive worsening should be expected during an acute episode.

This is actually an interesting question that I'd like to hear convo about. To the bolded, it should be noted that MOCA and MMSE are not specific for delirium and this should not be assumed. I've had quite a few non-delirious patients with dementia or TBIs fail those exams spectacularly as well.

 

[hebel]

To the bolded, it should be noted that MOCA and MMSE are not specific for delirium and this should not be assumed.

Absolutely! Thanks for clarifying. I would estimate I've actually used these more often in screening for dementia than delirium. And to add that that, I would never diagnose a neurocognitive disorder using any of the above screening tools either.

 

[Ironspy]

I don't think you can accurately measure cognition in acute mania or psychosis bc these patients often cannot sustain adequate attention to complete the assessments secondary to their mania/psychosis

 

[Crayola227]

Yes, I've always heard that whatever is going on in mania/psychosis makes it basically impossible to accurately assess cognitive function.

 

[ridethecliche]

No one suspects the spanish inquisition (cough FTD).