Examination and Disturbance of Intellectual Functions (MSE)

1. Overview & Definitions

Intelligence (Gajdos, Psychopathology I): a global ability of the person which enables them to think rationally, act practically and manage their surroundings effectively. In the UD model it is not a single function but the integrated product of memory/learning (5) + thinking (6) — i.e. intelligence = <5 + 6> together. So intellect can only be judged once you have already tested orientation, attention, memory and thinking.

Intellectual ("cognitive/intellectual") functions assessed at the bedside:

Function	What it probes
Fund of knowledge	General information stored over a lifetime; depends on education and culture
Calculation	Mental arithmetic / serial subtraction (also taxes attention & working memory)
Abstraction	Moving from the concrete particular to the general/metaphorical (proverbs, similarities)
Comprehension	Understanding instructions and situations (apperception — grasping meaning)
Judgment	Sound, practical decision-making in hypothetical/real situations
Insight	Awareness that one is ill and needs treatment

Two distinct uses of "intelligence" the examiner will separate:

Bedside intellect — clinical impression, no numbers, graded against the patient's education and social background.

Psychometric intelligence — a standardized, normed IQ score (WAIS/MAWI) read by a clinical psychologist.

Epidemiology / distribution: IQ in the population follows a Gaussian (normal) distribution, mean = 100, SD = 15. ~68% fall 85–115; ~2.3% below 70 (the conventional cut-off for intellectual disability); ~2.3% above 130. Intellectual disability has a lifetime prevalence of ~1–2%; it is lifelong and developmental, in contrast to acquired decline (dementia).

1. Overview & Definitions

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