Proverb familiarity and the mental status examination

Asking patients to interpret proverbs is a traditional method of assessing abstract thinking ability. Familiarity with a proverb increases the likelihood of interpreting it correctly. Differences in proverb familiarity among patients could lead clinicians to incorrectly conclude that a patient is thinking concretely, and thus to underestimate the patient's cognitive ability. Clinicians should be aware of this possibility when assessing patients from different racial and gender groups. The authors surveyed 229 Afro-American and 104 Caucasian high school students to determine their familiarity with 25 proverbs. Thirty-seven clinicians were also asked to rate their patients' familiarity with the same proverbs. The authors found no differences in proverb familiarity between the black and white students or the male and female students. Clinicians' beliefs about proverb familiarity in their patients were found to be inaccurate.