The Mental Status Examination in Neurology, 4th Edition by Richard Strub, M.D. & F. William Black, Ph.D.

F. A. Davis Publishers, 2000

From the Publisher: “This time-honored classic will prepare you to use a standardized mental status exam to diagnose organic brain disease and describe relative levels of functioning; and assess your patient’s mental status quickly and compare test scores with age-related norms to eliminate the need for more expensive tests.”

The Mental Status Examination in Neurology is an immensely useful, elegant little book of only 208 pages, expertly written and organized, for psychologists, physicians, and other health-care providers who assist individuals by neurological screening and referral.

“We did that book for one purpose,” Dr. Bill Black explained, “and that was to help us teach neurology residents how to evaluate patients behaviorally. There was no such thing back in 1977 when F.A. Davis first published it. It apparently hit a cord, residents are still buying it.”

Chapters are arranged methodically, as authors suggest that the exam “… be performed in a hierarchic manner, beginning with the most basic function–level of consciousness–and proceeding through the basic cognitive functions … to the more complex areas of verbal reasoning and calculating ability.”

In Chapter one, “The Mental Status Examination: A Rationale and Overview,” authors write, “Human behavior is extremely complex and multifaceted. Because of its complexity, it is not surprising that brain disease or dysfunction can significantly affect a patient’s behavior in a variety of ways.” The authors note reasons for an exam, including known or suspected brain lesions, psychiatric conditions, and “vague behavioral complaints.”

The text has demonstrated widespread appeal over three decades and four editions. It has been popular with neurology residents and psychology graduate students, providing an essential tool and understanding in a brief, straightforward exam.

The book is logically thought out and organized, with chapters matching the categories of test information and items: levels of consciousness, attention, language, memory, constructional ability, higher cognitive functions, and related cognitive functions. A summary chapter, relating results to various disorders, follows. “Further evaluations” and an appendix on “Standard Neuropsychological Assessment Methods” complete the book. The fourth edition sports a handy “pocket card,” with a summary of test items and concepts.

Even though there are more comprehensive texts now for those looking for greater detail and more current information, reviewers on Amazon continue to note that Examination is “very useful for trainees in psychiatry,” and that it helps the reader come away with confidence and clear concepts that are difficult to acquire.

“Dick Strub and I were teaching behavioral neurology to neurology residents and had a rotation in BN and NP for 4th year medical students,” Bill said, reflecting on how he came to write Examination. “In 1976, when the first edition was actually written, there was no good text to use in teaching the subject,” he said. “This was a time before all but one neuropsych book and any American behavioral neurology textbooks. We had a need, assumed that others in similar teaching situations had a similar need, and wrote the book to fill the need. Success was beyond our expectations.”

Will Bill and coauthor Richard Strub write a 5th edition? “In a word, no,” Bill explained. “We decided some years ago that the 4th edition would be the last. The need for the book in its 4 incarnations, as a teaching tool for neurology/psychiatry residents, is no longer strong. There are now many texts of behavioral neurology and mental status assessment – and most, not all, residency programs are now teaching behavioral neurology.”

“The use of the book by psychology graduate programs was an unexpected bonus,” he said. “Psychologists were not our primary target, although we tried to encourage the publisher, which is a medical publisher only, to market to the psychology audience when I learned that it had appeal. Essentially, they didn’t know how to deal with that market.”

Bill’s most enjoyable part of writing/publishing? “With both books and professional articles, the most enjoyment has been seeing and hearing from physicians and psychologists who read and enjoyed what we wrote.”

Dr. F. William Black is currently Medical Consultant in Neuropsychology for Unum Group. He is Emeritus Professor of Psychiatry and Neurology, Tulane University Health Sciences Center. Examination has been published in four languages, including Italian and Japanese. It is available through Amazon and other booksellers.

2 thoughts on “The Mental Status Examination in Neurology, 4th Edition by Richard Strub, M.D. & F. William Black, Ph.D.

  1. Robijn K Hornstra MD

    I have the 1977 edition and am looking to find another copy or buy another……. This is my favorite books to use to enhance teaching of the Mental Status Exam to Psychiatric Residents

    1. H.

      I know a little bookshop in holland that buys the fourth edition! Just bought it for my study last week.. If you want i can buy you a copy and send it to you.


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