The Screen for Cognitive Impairment in Psychiatry: Proposal for a polytomous scoring system

Differences in social perception in people with schizophrenia and bipolar disorder

People with schizophrenia have difficulties recognizing other people's expressions, emotional states, and intentions; however, much less is known about their ability to perceive and understand social interactions. We used scenes depicting social situations to compare responses from 90 volunteers (healthy controls [HC], schizophrenia [SZ], and bipolar disorder [BD] outpatients from the Hospital del Salvador in Valparaíso, Chile) to the question: "What do you think is happening in the scene?" Independent blind raters assigned a score of 0 (absent), 1 (partial), or 2 (present) for each item based on whether the description identifies a) the context, b) the people, and c) the interaction depicted in the scenes. Regarding the context of the scenes, the SZ and BD groups scored significantly lower than the HC group, with no significant difference between the SZ and BD groups. Regarding the identification of the people and the interactions, the SZ group scored lower than the HC and BD groups, with no significant difference between the HC and BD groups. An ANCOVA was used to examine the relationship between diagnosis, cognitive performance, and the results of the social perception test. The diagnosis had an effect on context (p = .001) and people (p = .0001) but not on interactions (p = .08). Cognitive performance had a significant effect on interactions (p = .008) but not on context (p = .88) or people (p = .62). Our main result is that people with schizophrenia may have significant difficulties perceiving and understanding social encounters between other people.

Dimensionality analysis of the German version of the Screen for Cognitive Impairment in Psychiatry (SCIP-G)

Background

Psychiatric disorders, especially schizophrenia, are characterised by cognitive impairment. The rapid detection of cognitive dysfunction - also in the course of the disease - is of great importance. The Screen for Cognitive Impairment in Psychiatry (SCIP) was developed to provide screening of psychiatric patients in clinical practice and is available in several languages. Prior psychometric investigations into the dimensionality of the SCIP have produced two different models: a one-factor model assumes that the five subscales of the SCIP load together, whereas an alternative model suggests that the subscales load on two factors, namely verbal memory and processing speed. We carried out a confirmatory factor analysis of the German version of the SCIP (SCIP-G).

Methods

323 patients with psychotic, bipolar affective, and depressive disorders were studied.

Results

The one-factor approach did not yield an acceptable model fit (chi-squared test: χ² = 109.5, df = 5, p < 0.001, χ²/df = 21.9). A two-factor solution, with the subtests Verbal Learning Test-Immediate Recall, Delayed Recall Test of the VLT, and Working Memory Test loading on the first factor, whereas the subtests Verbal Fluency Test and Psychomotor Speed Test loading on the second factor, obtained a good model fit (χ² = 6.7, df = 3, p = 0.08, χ²/df = 2.2).

Conclusions

These data show that a good model fit can be achieved with a two-factor solution for the SCIP. This study is the first to conduct a confirmatory factor analysis using the German SCIP version and to test its dimensional structure using a hypothesis-testing approach.

Factors associated with overall functioning in patients with schizophrenia in a general hospital in Peru

OBJECTIVE

To evaluate the influence of the factors associated with overall functioning in patients with schizophrenia who attended the outpatient clinic of the Hospital Nacional de la Policía [National Police Hospital] "Luis Nicasio Saenz" in 2018-2019.

METHODOLOGY

Non-experimental quantitative study of a descriptive cross-sectional correlational type. Convenience sampling was carried out, and consisted of 53 patients with schizophrenia. Functioning Assessment Short Test (FAST) was used to assess overall functioning, the Screen for Cognitive Impairment in Psychiatry (SCIP) for cognitive functioning, and a data collection sheet with sociodemographic data and a history of the disease.

RESULTS

It was found that 34 (62.2%) patients were male; 52 (98.1%), single; 39, (73.6%) without a current job. We found worse overall functioning in patients with a lower educational level (P = .005) and without a current job (P = .004). The total FAST was correlated with the time of the disease (ρ = 0.334, P < .05), the number of previous psychotic episodes (ρ = 0.354, P < .01), the total SCIP score (ρ = 0.542, P < .01) and their working memory dimension (VMT) (ρ = -0.523, P < .05). In the multiple linear regression model, it was found that the variables that most influenced the FAST were the total SCIP score (Beta = -0.528) and the number of previous psychotic episodes (Beta = 0.278).

CONCLUSION

The associated factors that most influence overall functioning in this sample of Peruvian patients with schizophrenia are cognitive functioning and the number of previous psychotic episodes.

Usefulness of a psychomotor function test as a cognitive function scale for patients with schizophrenia: A pilot study

As cognitive dysfunction due to schizophrenia is strongly associated with patients' social rehabilitation, cognitive functions have been examined as a therapeutic target. Although the Brief Assessment of Cognition in Schizophrenia (BACS) has been used to evaluate cognitive function, it is difficult to administer in routine clinical practice due to its time-consuming nature. Therefore, a novel tool is needed to facilitate the assessment of cognitive function. In the present study, we examined whether cognitive function can be assessed effectively by testing psychomotor function in patients with schizophrenia. Test batteries consisting of choice reaction time (CRT) and compensatory tracking task (CTT) and the BACS were examined in 20 schizophrenic patients to evaluate the correlation between the scales by Pearson correlation coefficient. Of the test batteries, the CRT was significantly correlated with attention functions, a subtest of the BACS (r = -0.506, p = 0.023), and the CTT was strongly correlated with attention functions (r = -0.716, p < 0.001) and working memory (r = -0.633, p = 0.003). A multiple regression analysis was performed to clarify the association between psychomotor function tests and the total BACS score, and peripheral awareness task, a component of CTT, was independently associated with the total BACS score (β = -0.59, p = 0.004) with an R2 of 0.37. Thus, of the psychomotor function tests, the CRT and the CTT are highly useful in assessing cognitive functions in schizophrenic patients. However, no having large sample size in this study is a limitation.

Italian Validation of the Screen for Cognitive Impairment in Psychiatry

Cognitive impairments have profound implications for the management of severe mental disorders; however, they are rarely assessed in everyday clinical practice due to constraints in time, resource and expertise. Novel and short instruments, such as the Screen for Cognitive Impairment in Psychiatry (SCIP), which overcome such limitations are greatly needed. The study aims to assess the validity and reliability, among healthy subjects, of the Italian translation of the SCIP, a brief, accessible tool to detect cognitive impairments among individuals suffering from mental disorders, as the first step to validate the instrument in clinical settings. One-hundred and twenty healthy subjects completed two of the three alternative forms of the SCIP. Cronbach Alpha (0.70) supported the reliability of the SCIP scores. Correlation coefficients supported the test-retest reliability of the tool. Learning effects were observed despite the use of alternative forms. Factor analysis indicated a two-factor solution explaining 55.4% of the total variance: the first factor ("memory") loading for VLT-I and VLT-D and less for WMT; the second factor ("executive function") loading for VFT and PST and less for WMT. The study proved the validity and reliability of the Italian version of the SCIP as a reliable and simple instrument to screen for cognitive impairment in the general population.

Altered brain function and clinical features in patients with first-episode, drug naïve major depressive disorder: A resting-state fMRI study

Major depressive disorder (MDD) is characterized by heterogeneous clinical performance and neurocognitive impairment. It is important to explore the correlation between global functioning and regional homogeneity (ReHo)/amplitude of low-frequency fluctuation (ALFF) values in MDD patients. 67 first-episode, drug naïve MDD patients and 69 healthy subjects were enrolled in the study. The MATRICS Consensus Cognitive Battery (MCCB) and the Functioning Assessment Short Test (FAST) were used to assess functional impairment in patients. Brain activity was assessed using ReHo and ALFF measurements. The relationship between the clinical features and altered brain function was evaluated using correlation analysis. There were significant differences in the ReHo and ALFF values between MDD patients and healthy subjects. The reduction in ReHo in the left calcarine/lingual gyrus/cuneus was negatively correlated with occupational functioning and the total FAST scores. The reduction in ALFF in the right calcarine/lingual gyrus was positively correlated with the verbal learning aspects of the MCCB. These findings suggest that the altered brain function in the default mode network (DMN) may be related to functional impairments in patients with first-episode, drug naïve major depressive disorder.

Factors Associated with Overall Functioning in Patients with Schizophrenia in a General Hospital in Peru

OBJECTIVE

To evaluate the influence of the factors associated with overall functioning in patients with schizophrenia who attended the outpatient clinic of the Hospital Nacional de la Policía [National Police Hospital] "Luis Nicasio Saenz" in 2018-2019.

METHODOLOGY

Non-experimental quantitative study of a descriptive cross-sectional correlational type. Convenience sampling was carried out, and consisted of 53 patients with schizophrenia. Functioning Assessment Short Test (FAST) was used to assess overall functioning, the Screen for Cognitive Impairment in Psychiatry (SCIP) for cognitive functioning, and a data collection sheet with sociodemographic data and a history of the disease.

RESULTS

It was found that 34 (62.2%) patients were male; 52 (98.1%), single; 39, (73.6%) without a current job. We found worse overall functioning in patients with a lower educational level (p=0.005) and without a current job (p=0.004). The total FAST was correlated with the time of the disease (ρ=0.334, p <0.05), the number of previous psychotic episodes (ρ=0.354, p <0.01), the total SCIP score (ρ=0.542, p <0.01) and their working memory dimension (VMT) (ρ=-0.523, p <0.05). In the multiple linear regression model, it was found that the variables that most influenced the FAST were the total SCIP score (Beta=-0.528) and the number of previous psychotic episodes (Beta=0.278).

CONCLUSION

The associated factors that most influence overall functioning in this sample of Peruvian patients with schizophrenia are cognitive functioning and the number of previous psychotic episodes.

Screening for cognitive impairment in non-affective psychoses: A comparison between the SCIP and the MoCA

BACKGROUND

Neuropsychological performance has a strong impact on real-life functioning and clinical outcomes in psychosis. However, conducting lengthy cognitive assessments may not be feasible in routine clinical practice. Brief, reliable and cost-effective tools are highly needed, but few studies are available to guide clinician choice.

METHODS

The purpose of this study was to compare the performance of two widely used, short instruments: the Screen for Cognitive Impairment in Psychiatry (SCIP) and the Montreal Cognitive Assessment (MoCA). These instruments were validated in a sample of patients with psychotic disorders and healthy controls, using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and other instruments to assess executive functions, as comparators.

RESULTS

Patients fared worse than controls across almost all cognitive domains, with effect sizes ranging from 0 (MoCA naming) to 2.08 (SCIP total). Receiver Operator Curve analysis of patient and control performance suggested a better convergent validity for the SCIP (total score AUC: 0.85; 95%CI: 0.79-0.90; Se: 76%, Sp: 83%, PPV: 85%, NPV: 73%) than the MoCA (AUC: 0.78; 95%CI: 0.72-0.85; Se: 69%, Sp: 76%, PPV: 78.7%, NPV 66%).

CONCLUSIONS

The Screen for Cognitive Impairment in Psychiatry seems to be a more sensitive and specific screening tool than the MoCA to identify cognitive impairment among patients with psychotic disorders.

A Method of FPGA-Based Extraction of High-Precision Time-Difference Information and Implementation of Its Hardware Circuit

The positioning technology to find shallow underground vibration sources based on a wireless sensor network is receiving great interest in the field of underground position measurements. The slow peaking and strong multi-waveform aliasing typical of the underground vibration signal result in a low extraction accuracy of the time difference and a poor source-positioning accuracy. At the same time, the transmission of large amounts of sensor data and the host computer’s slow data processing speed make locating a source a slow process. To address the above problems, this paper proposes a method for high-precision time-difference measurements in near-field blasting and a method for its hardware implementation. First, based on the broadband that is typical of blast waves, the peak frequency of the P-wave was obtained in the time–frequency domain, taking advantage of the difference in the propagation speed of the P-wave, S-wave, and the surface wave. Second, the phase difference between two sensor nodes was found by means of a spectral decomposition and a correlation measurement. Third, the phase ambiguity was eliminated using the time interval of the first break and the dynamic characteristics of the sensors. Finally, following a top-down design idea, the hardware system was designed using Field Programmable Gate Array(FPGA). Verification, using both numerical simulations and experiments, suggested that compared with generalized cross-correlation-based time-difference measurement methods, the proposed method produced a higher time-difference resolution and accuracy. Compared with the traditional host computer post-position positioning method, the proposed method was significantly quicker. It can be seen that the proposed method provides a new solution for solving high-precision and quick source-location problems, and affords a technical means for developing high-speed, real-time source-location instruments.

Amplitude of low-frequency fluctuation (ALFF) may be associated with cognitive impairment in schizophrenia: a correlation study

BACKGROUND

Cognitive impairments are prominent in schizophrenia (SZ). Imaging studies have demonstrated that functional changes of several areas of the brain exist in SZ patients. The relationships between these two indexes are largely unexplored in SZ. The MATRICS Consensus Cognitive Battery (MCCB) was used to measure cognitive impairment in multi-dimensional cognitive fields of SZ patients. This study was conducted to explore the relationship between cognitive functional impairment and the amplitude of low-frequency fluctuation (ALFF) in SZ patients.

METHOD

A total of 104 participants (44 SZ patients and 60 age- and gender-matched healthy controls (HC)) were recruited for this study. The MCCB was used to assess cognitive function of the participants, while brain activity was assessed using the ALFF. The relationship between the MCCB and the ALFF was investigated by using a correlation analysis.

RESULTS

There were significant differences between SZ patients and HC in MCCB total and domain scores as well as in ALFF results. The reduction of ALFF in the bilateral postcentral gyri and paracentral lobule in SZ patients has a negative correlation with the MCCB sub-test of symbol coding.

CONCLUSION

These findings suggest that the reduction of ALFF in bilateral postcentral gyri and paracentral lobule may be related to cognitive impairment in SZ patients.

The Screen for Cognitive Impairment in Psychiatry: Proposal for a polytomous scoring system

The Screen for Cognitive Impairment in Psychiatry is a simple, fast, and easy to administer scale that has been validated in clinical and community samples. The aim of this study was to propose a polytomous scoring system for the Screen for Cognitive Impairment in Psychiatry and to demonstrate its functioning, thus providing new and complementary information regarding the utility and precision of this screening tool. Three hundred seventy-six Spanish patients diagnosed with schizophrenia spectrum disorder were evaluated. A polytomous scoring system was generated and analyzed by means of the partial credit model. Category assessment revealed optimal functioning after collapsing the 7-category system to 1 with either 5 or 4 categories, depending on the item. The proposed polytomous scoring system shows good psychometric properties and an adequate fit to the partial credit model. These results provide further confirmation of the test's utility in clinical settings and of its suitability for detecting cognitive impairment.