The use of a mental status examination in a chemical dependence treatment program

Current chemical dependence treatment programs place significant cognitive demands on patients early in abstinence. Unfortunately, many chemically dependent persons have significant cognitive deficits in the acute and post-acute stages of withdrawal. Constraints on resources often make thorough evaluation of cognitive status impractical. We examined the utility of a brief structured mental status examination, the Cognitive Capacity Screening Examination (CCSE), to identify cognitive deficits within the first week of admission to an inpatient chemical dependence treatment program. Although both age and educational level influenced CCSE total score to a statistically significant degree, the magnitude of their influence was of doubtful clinical importance. Findings suggest that the CCSE total score is not sufficiently sensitive to detect the deficits seen in chemically dependent individuals. However, a more detailed item analysis can provide useful information to the clinician. Normative data and recommendations for use of the CCSE with chemically dependent populations are provided.