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Haddad C, Sacre H, Abboche E, Salameh P, Calvet B. The self-assessment scale of cognitive complaints in Schizophrenia: validation of the Arabic version among a sample of lebanese patients. BMC Psychiatry 2023; 23:415. [PMID: 37296387 PMCID: PMC10257267 DOI: 10.1186/s12888-023-04925-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/05/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Several subjective scales have been used to measure cognitive complaints in patients with schizophrenia, such as the Self-Assessment Scale of Cognitive Complaints in Schizophrenia (SASCCS), which was designed to be clear, simple, and easy to use. This study aimed to examine the ability of SASCCS as a validated tool to collect and assess subjective cognitive complaints of patients with schizophrenia. METHODS A cross-sectional study among 120 patients with schizophrenia was performed between July 2019 and Mars 2020 at the Psychiatric Hospital of the Cross, Lebanon. The SASCCS was used to assess how patients with schizophrenia perceived their cognitive impairment. RESULTS The internal consistency of the SASCCS scale was 0.911, and the intra-class correlation coefficient was 0.81 (p < 0.001), suggesting a good stability over time. The factor analysis of the SASCCS scale showed a 5-factor solution using the Varimax rotated matrix. The SASCCS total score positively correlated with their own factors. A negative correlation was found between the objective cognitive scale and subjective cognitive complaints, which were positively correlated with clinical symptoms and depression. No significant association was found between insight and subjective cognitive complaints. CONCLUSION The SASCCS scale showed appropriate psychometric properties, with high internal consistency, good construct validity, and adequate concurrent validity, which makes it valuable for the evaluation of subjective cognitive complaints in patients with schizophrenia.
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Affiliation(s)
- Chadia Haddad
- EpiMaCT - Epidémiologie des maladies chroniques en zone tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, OmegaHealth, Limoges, France.
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon.
- School of Medicine, Lebanese American University, Byblos, Lebanon.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- School of Health Sciences, Modern University for Business and Science, Beirut, Lebanon.
| | - Hala Sacre
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
| | - Elie Abboche
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Pascale Salameh
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
- School of Medicine, Lebanese American University, Byblos, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Egkomi, Nicosia, 2417, Cyprus
| | - Benjamin Calvet
- EpiMaCT - Epidémiologie des maladies chroniques en zone tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, OmegaHealth, Limoges, France
- Pôle Universitaire de Psychiatrie de l'Adulte et de la Personne Âgée, Centre Hospitalier Esquirol, Limoges, 87000, France
- Unité de Recherche et d'Innovation, Centre Hospitalier Esquirol, Limoges, 87000, France
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Kalinich M, Ebrahim S, Hays R, Melcher J, Vaidyam A, Torous J. Applying machine learning to smartphone based cognitive and sleep assessments in schizophrenia. Schizophr Res Cogn 2022; 27:100216. [PMID: 34934638 PMCID: PMC8655108 DOI: 10.1016/j.scog.2021.100216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 09/09/2021] [Accepted: 09/19/2021] [Indexed: 11/19/2022] Open
Abstract
Background Methods Results Discussion
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Affiliation(s)
- Mark Kalinich
- Harvard Medical School, Boston, MA, USA
- Watershed Informatics, Inc., Boston, MA, USA
| | - Senan Ebrahim
- Harvard Medical School, Boston, MA, USA
- Delfina Inc., Boston, MA, USA
| | - Ryan Hays
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jennifer Melcher
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Aditya Vaidyam
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - John Torous
- Harvard Medical School, Boston, MA, USA
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Corresponding author at: Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215, USA.
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Haddad C, Salameh P, Sacre H, Polin C, Clément JP, Calvet B. Subjective cognitive complaints and relations to objective cognitive performance among Lebanese patients with schizophrenia. BMC Psychiatry 2021; 21:549. [PMID: 34753438 PMCID: PMC8576858 DOI: 10.1186/s12888-021-03564-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/26/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Patients with schizophrenia have a particularly low level of insight into their illness compared to people with other mental health disorders. The objectives of the study were to evaluate: 1) subjective cognitive complaints in individuals with schizophrenia in comparison with health controls, 2) the relation between subjective cognitive complaint (SCC) and objective cognitive performance in the patients group, and 3) factors related to cognitive complaint, such as depression, insight, autonomy, and psychological symptoms. METHODS Cross-sectional study was conducted between July 2019 and March 2020 enrolled 120 patients with schizophrenia disorders, selected from the Psychiatric Hospital of the Cross (HPC) - Lebanon and 60 healthy controls. The Self-Assessment Scale of Cognitive Complaints in Schizophrenia (SASCCS) was used to measure people living with schizophrenia perception of their cognitive impairment, while the Brief Assessment of Cognition in Schizophrenia (BACS) was used to evaluate their cognitive functioning. RESULTS A significant difference was found between schizophrenia patients and healthy controls in all neurocognition and SASCCS tests. The hierarchical regression analysis showed that the BACS total score (Beta = -.06, p = .04), the PANSS general psychopathology (Beta = .29, p = .003), higher depression (Beta = .75, p = .003) were significantly associated with higher SCC. However, higher autonomy (Beta = - 6.35, p = .001) was significantly associated with lower SCC. A Structural equation model showed that the two most contributing variables were general psychopathology (Standardized Beta (SB): .33, p < 0.001) and autonomy (SB: -.29, p < 0.001). CONCLUSION A significant proportion of patients with schizophrenia could estimate their cognitive impairment. It also showed a positive correlation between depression and activity of daily living with SCC, suggesting that this aspect should be investigated alongside the clinical symptoms when a patient with schizophrenia presents with SCC.
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Affiliation(s)
- Chadia Haddad
- Research department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon. .,INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon. .,INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, 87000, Limoges, France. .,Pôle Universitaire de Psychiatrie de l'Adulte, de l'Agée et d'Addictologie, centre hospitalier Esquirol, 87025, Limoges, France.
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon ,grid.411324.10000 0001 2324 3572Faculty of Pharmacy, Lebanese University, Beirut, Lebanon ,grid.413056.50000 0004 0383 4764University of Nicosia Medical School, Nicosia, Cyprus
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Clément Polin
- grid.9966.00000 0001 2165 4861INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, 87000 Limoges, France ,grid.477071.20000 0000 9883 9701Pôle Universitaire de Psychiatrie de l’Adulte, de l’Agée et d’Addictologie, centre hospitalier Esquirol, 87025 Limoges, France ,grid.477071.20000 0000 9883 9701Centre mémoire de ressources et de recherche du Limousin, centre hospitalier Esquirol, 87025 Limoges, France
| | - Jean-Pierre Clément
- grid.9966.00000 0001 2165 4861INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, 87000 Limoges, France ,grid.477071.20000 0000 9883 9701Pôle Universitaire de Psychiatrie de l’Adulte, de l’Agée et d’Addictologie, centre hospitalier Esquirol, 87025 Limoges, France ,grid.477071.20000 0000 9883 9701Centre mémoire de ressources et de recherche du Limousin, centre hospitalier Esquirol, 87025 Limoges, France
| | - Benjamin Calvet
- grid.9966.00000 0001 2165 4861INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, 87000 Limoges, France ,grid.477071.20000 0000 9883 9701Pôle Universitaire de Psychiatrie de l’Adulte, de l’Agée et d’Addictologie, centre hospitalier Esquirol, 87025 Limoges, France ,grid.477071.20000 0000 9883 9701Centre mémoire de ressources et de recherche du Limousin, centre hospitalier Esquirol, 87025 Limoges, France ,grid.477071.20000 0000 9883 9701Unité Recherche et Innovations, centre hospitalier Esquirol, 87025 Limoges, France
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Cella M, Bodnar M, Lepage M, Malla A, Joober R, Iyer S, Wykes T, Preti A. Investigating subjective cognitive complaints in psychosis: Introducing the brief scale to Investigate cognition in schizophrenia (SSTICS-Brief). Cogn Neuropsychiatry 2020; 25:190-200. [PMID: 32028842 DOI: 10.1080/13546805.2020.1722084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Cognitive difficulties are a core deficit for people with schizophrenia and are generally assessed with neuropsychological tests. Self-report assessments are also useful in understanding difficulties from the service user's perspective. This study aims to introduce and test the shorter version of the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) to improve its acceptability and comprehensibility.Methods: In consultation with service users and clinicians, we identified items from the original 21-item SSTICS that were found difficult and these were excluded. The reduced scale was explored with Confirmatory Factor Analysis (CFA) in two independent samples in the UK and Canada. Convergent validity with symptoms and IQ was assessed and compared between the original and the reduced scale.Results: Six-hundred and seven people with schizophrenia and first-episode psychosis took part in this study. Seven items were removed to produce the SSTICS-Brief. This had good reliability and the CFA confirmed a unidimensional structure. Convergent validity with symptoms and IQ were optimal between the long and short versions.Conclusions: The SSTICS-B has better acceptability than its longer form and could be administered in less time. The resulting measure is likely to be a valuable short self-assessment of cognitive complaints for people with schizophrenia.
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Affiliation(s)
- Matteo Cella
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Trust, London, UK
| | - Michael Bodnar
- The Royal Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Martin Lepage
- Department of Psychiatry, McGill University & Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada
| | - Ashok Malla
- Department of Psychiatry, McGill University & Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada
| | - Ridha Joober
- Department of Psychiatry, McGill University & Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada
| | - Srividya Iyer
- Department of Psychiatry, McGill University & Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada
| | - Til Wykes
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Trust, London, UK
| | - Antonio Preti
- Center for Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Cagliari, Italy
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Baliga SP, Kamath RM, Kedare JS. Subjective cognitive complaints and its relation to objective cognitive performance, clinical profile, clinical insight, and social functioning in patients of schizophrenia: A cross-sectional study. Indian J Psychiatry 2020; 62:178-185. [PMID: 32382178 PMCID: PMC7197831 DOI: 10.4103/psychiatry.indianjpsychiatry_639_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/28/2019] [Accepted: 02/11/2020] [Indexed: 12/01/2022] Open
Abstract
CONTEXT Neurocognitive deficits are well documented in schizophrenia. Neurocognitive insight (NI), described as awareness of neurocognitive deficits, has not been evaluated in the Indian context. Its relation to clinical profile and social functioning also remains unexplored. AIMS The aim of this study was to evaluate the subjective cognitive complaints (SCCs) and their relation to objective cognitive performance, clinical profile, clinical insight, and social functioning in patients of schizophrenia. SETTINGS AND DESIGN This was a cross-sectional study at the outpatient department of a tertiary care teaching hospital. MATERIALS AND METHODS One hundred individuals with schizophrenia were evaluated using Positive and Negative Syndrome Scale, Subjective Scale To Investigate Cognition in Schizophrenia, abbreviated version of Scale to Assess Unawareness in Mental Disorders, and Schizophrenia Research Foundation-Social Functioning Index. Cognitive performance was assessed using (1) Digit Span Test (attention) from Wechsler Adult Intelligence Scale, 3rd edition and (2) Passages Test (explicit memory), (3) Verbal n-back Test (working memory), and (4) Stroop Test (executive functioning) from the National Institute of Mental Health and Neuro Sciences Battery. STATISTICAL ANALYSIS Statistical analysis was done using descriptive statistics, nonparametric tests, and Pearson's coefficient of correlation. RESULTS Participants showed impairment in all cognitive domains. Except for working memory, there was no correlation between SCC and objective performance for other cognitive domains correspondingly, implying poor NI. Severity of psychosis and clinical insight did not have any correlation with SCC. Higher SCC correlated with poorer social functioning, especially in "occupational" and "other social roles" domains. CONCLUSIONS Individuals with schizophrenia have poor NI. This is independent of severity of psychosis or clinical insight into illness. Socio-occupational functioning and depression should be actively enquired into when patients present with SCC.
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Affiliation(s)
- Sachin Pradeep Baliga
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Ravindra M Kamath
- Department of Psychiatry, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
| | - Jahnavi S Kedare
- Department of Psychiatry, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
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Raffard S, Lebrun C, Bayard S, Macgregor A, Capdevielle D. Self-Awareness Deficits of Cognitive Impairment in Individuals With Schizophrenia. Really? Front Psychiatry 2020; 11:731. [PMID: 32848912 PMCID: PMC7406784 DOI: 10.3389/fpsyt.2020.00731] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 07/13/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Misestimation of cognitive functioning has been largely described in individuals with schizophrenia. There is large evidence that correlations between subjectively assessed cognitive functioning and objectively determined cognitive functioning are weak in non clinical individuals and may be more closely related to other psychoaffective or clinical factors than to objective neuropsychological functioning. Surprisingly, no study to date has compared the associations between cognitive complaint and objective measures of cognitive functioning in individuals with schizophrenia and healthy controls. The main objective of this study was to 1) compare cognitive complaint between individuals with schizophrenia and non clinical controls, 2) explore the relationships between cognitive complaint and psychoaffective and clinical factors in the clinical group and 3) compare the relationships between subjective awareness of cognitive functioning and objective neuropsychological assessment in individuals with schizophrenia and non-clinical participants. METHOD In this study 30 individuals with schizophrenia and 20 non-clinical matched controls were included. In addition to objective cognitive measures and subjective cognition assessed by the Subjective Scale To Investigate Cognition In Schizophrenia, measures of psychotic symptoms, depression, and anxiety were included. RESULTS Schizophrenia patients reported higher cognitive complaints in comparison with controls. In individuals with schizophrenia, cognitive complaint subscores were differently associated with depression, anxiety, and negative symptoms. When depression was controlled for, the same number of correlations between self-rated measures of cognition and objective measures of cognition were found in both groups, but accuracy of self-assessment of cognition was lower in the schizophrenia group.When the schizophrenia group was divided into a high cognitive complaint group (SZ High CC) and a low cognitive complaint group (SZ Low CC), findings indicated that self-assessment of cognition in the SZ high CC was highly accurate (correlations with large effect sizes). By contrast the SZ low CC group severely misjudge their cognition. CONCLUSION A significant proportion of patients with schizophrenia can accurately estimate their cognitive skills. Self-awareness of cognitive deficits in individuals with schizophrenia is an heterogenous phenomenon and misestimation of cognitive functioning might have been overestimated, partly due to secondary psychoaffective factors. Caution is warranted before jumping to the conclusion that all individuals with schizophrenia misjudge their cognitive functioning.
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Affiliation(s)
- Stéphane Raffard
- Univ Paul Valéry Montpellier 3, Univ Montpellier, EPSYLON EA 4556, Montpellier, France.,Service Universitaire de Psychiatrie Adulte, Hôpital de la Colombière CHU Montpellier, Montpellier, France
| | - Cindy Lebrun
- Univ Paul Valéry Montpellier 3, Univ Montpellier, EPSYLON EA 4556, Montpellier, France
| | - Sophie Bayard
- Univ Paul Valéry Montpellier 3, Univ Montpellier, EPSYLON EA 4556, Montpellier, France
| | - Alexandra Macgregor
- Service Universitaire de Psychiatrie Adulte, Hôpital de la Colombière CHU Montpellier, Montpellier, France
| | - Delphine Capdevielle
- Service Universitaire de Psychiatrie Adulte, Hôpital de la Colombière CHU Montpellier, Montpellier, France.,Inserm, U1061, Montpellier, France.,University of Montpellier, Montpellier, France
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