Our list is far from complete because we likely are unaware of many mnemonics, and we have excluded some that seemed obscure, unwieldy, or redundant. We have not excluded mnemonics that some may view as pejorative but merely report their existence. Including them does not mean that we endorse them.
This article lists 32 mnemonics related to psychiatric diagnosis. Thus, it seems odd that an informal survey of >60 residents at the Massachusetts General Hospital (MGH)/McLean Residency Training Program in Psychiatry revealed that most were aware of only 2 or 3 psychiatric mnemonics, typically:
- SIG: E CAPS (a tool to recall the criteria for depression)
- DIG FAST (a list of criteria for diagnosing mania)
- WWHHHHIMPS (a tool for recalling life-threatening causes of delirium).
Although this unscientific survey may be biased because faculty or trainees at MGH created the above 3 mnemonics, it nonetheless begs the question of what qualities make a mnemonic memorable.
Learning theory provides several clues. George Miller’s classic 1956 paper, “The magical number seven, plus or minus two: some limits on our capacity for processing information,” discussed the finding that 7 seems to be the upper limit of individual pieces of data that can be easily remembered.31 Research also has shown that recruiting the limbic system (potentially through the use of humor) aids in the recall of otherwise dry, cortical information.32,33
Intuitively, it would seem that nonrepeating letters would facilitate the recall of the linked data, allowing each letter to provide a distinct cue, without any clouding by redundancy. Of the 3 most popular psychiatric mnemonics, however, only DIG FAST fits the learning theory. It contains 7 letters, repeats no letters, and has the limbic cue of allowing the learner to imagine a person with mania digging furiously.
MNEMONICS FOR DIAGNOSING ADDICTION DISORDERS
| Substance dependence ADDICTeD12 Activities are given up or reduced Dependence, physical: tolerance Dependence, physical: withdrawal Intrapersonal (Internal) consequences, physical or psychological Can’t cut down or control use Time-consuming Duration or amount of use is greater than intended | Substance abuse WILD12 Work, school, or home role obligation failures Interpersonal or social consequences Legal problems Dangerous use | Alcohol abuse CAGE13 Have you ever felt you should CUT DOWN your drinking? Have people ANNOYED you by criticizing your drinking? Have you ever felt bad or GUILTY about your drinking? Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (EYE-OPENER)? |
SIG: E CAPS falls within the range of 7 plus or minus 2, includes a limbic cue (although often forgotten, it refers to the prescription of energy capsules for depression), but repeats the letter S.
WWHHHHIMPS, with 10 letters, exceeds the recommended range, repeats the W (appearing twice) and the H (appearing 4 times), and provides no clear limbic cue.
MNEMONICS FOR DIAGNOSING DELIRIUM
| Causes I WATCH DEATH Infection Withdrawal Acute metabolic Trauma CNS pathology Hypoxia Deficiencies Endocrinopathies Acute vascular Toxins or drugs Heavy metals | Life-threatening causes WWHHHHIMPS* Wernicke’s encephalopathy Withdrawal Hypertensive crisis Hypoperfusion/hypoxia of the brain Hypoglycemia Hyper/hypothermia Intracranial process/infection Metabolic/meningitis Poisons Status epilepticus * Created by Gary W. Small, MD | Deliriogenic medications ACUTE CHANGE IN MS14 Antibiotics Cardiac drugs Urinary incontinence drugs Theophylline Ethanol Corticosteroids H2 blockers Antiparkinsonian drugs Narcotics Geriatric psychiatric drugs ENT drugs Insomnia drugs NSAIDs Muscle relaxants Seizure medicines |
It may be that recruiting the limbic system provides the greatest likelihood of recall. Recruiting this system may add increased valence to a particular mnemonic for a specific individual, but this same limbic valence may limit its usefulness in a professional context.
- Free searchable database of medical mnemonics. www.medicalmnemonics.com.
- Robinson DJ. Mnemonics and more for psychiatry. Port Huron, MI: Rapid Psychler Press, 2001.