The usefulness of mental health diagnostic screening in patients with isolated cerebellar lesions
Krzysztof Jodzio
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Objectives: The present study evaluated the diagnostic usefulness of selected screening methods for mental disorders in patients with cerebellar lesions. Specifically, the aim was to determine which screening methods allow for rapid identification of executive dysfunctions. Materials and methods: Twenty-five patients with an isolated cerebellar lesion were included in the study. A set of three popular screening methods, i.e. Mini–Mental State Examination, Clock Completion Test, and the Brief Psychiatric Rating Scale, was used. A multivariate regression analysis was conducted to assess their diagnostic accuracy as independent predictors of results in Wisconsin Card Sorting Test and Stroop Color-Word Test, defined as dependent variables. Results: The scores obtained by most patients in the Mini–Mental State Examination indicate very mild to mild cognitive impairment, with a mean score of 26.84 ± 3.44. However, a clinically significant deterioration typically seen in dementia was found in 3 persons (12%). For comparison, an abnormal Clock Test score was found in two patients. According to the clinical profile based on the Brief Psychiatric Rating Scale, selective symptoms of a neurotic rather than strictly psychotic nature, such as somatic concern, emotional tension, and anxiety-depressive symptoms, dominated. Finally, only the Mini–Mental and the Brief Psychiatric Rating Scale emerged in the regression analysis as important and independent predictors of executive dysfunctions. Thus, the diagnostic utility of the Clock Test is limited. Conclusions: Some of the mental screening techniques could be useful as a measure of both the general severity of deterioration, as well as specific cognitive and executive disorders following cerebellar damage.