The write stuff: Relationships between narrative content and psychiatric illness

Clinicians often wonder if the single sentence from the Folstein Mini-Mental Status Exam (MMSE) offers meaningful information about the patient. We compared single sentences derived from the MMSE generated by 3 groups of participants — hospitalized medically-ill patients with psychiatric comorbidity, hospitalized medically-ill patients without psychiatric comorbidity, and non-hospitalized non-psychiatric participants. These sentences were analyzed for themes using manual thematic coding and a semi-automatic computerized method, the Meaning Extraction Method (MEM). We found that thematic content obtained from as little as a single sentence could differentiate between participant groups using both methods. Specifically, psychiatric patients used more power themes, focused on states other than the present, and were less interpersonally engaged than the other groups. Thematic content also indicated cognitive status through scores on the Clock Drawing Test (CDT) and MMSE. Our findings suggest that a single sentence can provide meaningful information about patients with medical and psychiatric comorbidity.