SCREENING OF ORGANIC BRAIN DYSFUNCTION

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Assistant Professor in Clinical Psychology \ Department of Psychiatry, Post ... J 160012. * Work was supported by research grant from the Indian Council of ...
Indian J. Psychiat. (1984), 26(4), 349 — 355 SCREENING OF ORGANIC BRAIN DYSFUNCTION* DWARKA PERSHADi, P h . D . , D . M . & S.P. S . K . VERMA', Ph.D., D.G.P., D.M. & S.P. SAV1TA M A L H O T R A 8 , M . D . (Psychiat.) S. PRABHAKAR 1 , M.D., D.M. (Neurol.) SUMMARY One hundred eighty adult patients (age 20 to 50 years) referred to Psychology section for differential diagnosis of brain pathology from 1976 to 1980 and where at least two of the three cognitive functions-intelligence, memory, and percepto motor ability, were tested and clinical diagnosis arrived at follow-ups, etc. were included. Ninteen psychological test variables were rescored to minimize the effect of age and education. Frequency distributions, separately for brain damage and non-brain damage patients for each variable were obtained and ogives prepared to find out points of maximum differentiations. Scores were assigned ratings o f 0 , 2 & 3 f o r average to low scores, and combined rating could identify about 2/3rd oforganics correctly amongst the difficult to diagnose c d e p e n d i n g u p o n subjects' a g e , e d u c a t i o n a n d sex were d e t e r m i n e d now using tables of n o r m s (I. G. M . R . — r e p o r t , V e r m a el al., 1983) for each of the four tests a n d verbal I . Q, was calculated. A difference between verbal a n d p e r formance I . Q,. was also calculated. (b) Memory P. G. I. M e m o r y scale (Pershad, 1977) consisting of ten subtests was a d m i n i s t e r e d . R a w scores o n each of the subtests were assigned Q u i n t i l e scores separately for the subjects of different e d u c a t i o n . A score of 2 was assigned when a score fell below 20th percentile a n d 4, 6, 8 w h e n scores fell below 40th, 60th a n d 80th percentile respectively. (c) Percepto-motor acuity T w o tests-Bender visual motor gestalt test (Bender, 1938) a n d N a h o r Benson test of organicity CNahor a n d Benson, 1970 ; Pershad a n d V e r m a , 1978) w e r e administered. T h e first test was scored following H a i n ' s (1964) m e t h o d a n d second test was scored on the basis of 'all or n o n e ' i.e. either a r e p r o d u c t i o n is correct or i n c o r r e c t . Brain Dysfunction Rating All the

psychological

test

scores

were not available in all the 180 (55 organic b r a i n dysfunction—'BD' and 125 non organic brain dysfunction—'NBD') cases. Various test scores were available in 37 to 48 cases of BD and 73 to 116 NBD cases, and all the scores for each subject were available only in 87 (27 BD a n d 60 NBD) cases. Frequency distributions of each of the 19 test scores were p r e p a r e d , separately for B. D . and N B D cases a n d ogives were plotted. Points oi m a x i m u m differentiations were located. These points/ scores were then assigned a r b i t r a r y , numerical ratings i n d i c a t i n g - ' n o deviation', 'deviation', a n d 'great deviation'. Different models were tried for this. For example, greatly deviant on each test variable a r a t i n g of 3 deviant a rating of 2 a n d no deviation a rating of 1 or r a t i n g s of 3/2/0 or 2/1/0 respectively. R a t i n g of 3 , 2, 0 was found to b e more useful. S u m of ratings on all the 19 test variables so scored was called total b r a i n d a m a g e score (B.D.S.). RESULTS T h e r a t i n g s for each of t h e 19 test variables for their different r a w scores a r e given below. T h e patients whose scores on the 19 variables were available w e r e taken hereafter for finding out cutoff points for three m a i n psychological functions included here. T A B L E 1—Rating Sheet of Organic Brain Dysfunction Battery SI. Test Variables No. Subtests

Rating Scale

1. *P -X 100

K 2. Performance Intelligence 3. Information 4. Digit Span

251+

60 60 60

200-250 upto 199

61-80 61-80 61-80

81 + 81 + 81 +

DWARKA PERSHAD etel.

352 5. 6. 7.

Arithmetic Comprehension • 'Difference of P