Psychiatric screening on a neurological ward.

Two psychiatric screening instruments, the Mini-Mental State (MMS), a test for cognitive disturbance, and the General Health Questionnaire (GHQ), were administered to 197 neurological in-patients. The results suggest a high rate of psychiatric disturbance. The highest rate of cognitive disturbance detected by the MMS was found in patients with Parkinson's disease. The highest rates of emotional disturbance indicated by GHQ scores were related to myasthenia gravis and multiple sclerosis. MMS scores but not GHQ scores were related to standard tests of cognition, the diagnosis of cerebral pathology, and CAT scan abnormality. The results also demonstrate that the GHQ does not adequately detect patients with cognitive impairment. It is concluded that in populations at high risk for cognitive impairment a tandem screening procedure utilizing tests for both cognitive and emotional disorders is needed.