Abstract

BackgroundCognitive impairment is a core feature of schizophrenia that also has strong prognostic significance. In most clinical settings comprehensive neuropsychological testing to detect cognitive impairment in schizophrenia patients is not readily available, but because cognitive deficits in schizophrenia are clinically important it would be useful to detect or at least screen for them in a clinical setting. Unfortunately there are no validated, brief screening instruments for the detection of cognitive impairment in schizophrenia. Nevertheless, the Montreal Cognitive Assessment Test (MoCA) and the Mini-Mental State Examination (MMSE) show promise in this regard. The objective of this study was to compare the results of the MMSE and MoCA in a group of outpatient schizophrenia sufferers to contribute to research into the instruments’ potential usefulness as screening tools for cognitive impairment in schizophrenia.MethodThe Afrikaans versions of the MMSE and MoCA were administered to Afrikaans-speaking adult outpatients. Participants had at least seven years of formal education and had been in partial or full remission for at least 3 months. The MMSE and MoCA scores for each participant were matched and compared using the non-parametric Wilcoxon matched pairs test.ResultsThe sample consisted of 30 Afrikaans-speaking outpatients with schizophrenia. The mean MMSE score was 27.17 ± 2.64, and the mean MoCA score was 22.53 ± 3.91. There was a statistically significant difference between participants’ performance on the MMSE and MoCA tests (p = 0.000008).ConclusionCompared to the MMSE, the MoCA may be a more useful instrument to detect cognitive impairment in patients with schizophrenia. Further studies are required.

Highlights

  • Cognitive impairment is a core feature of schizophrenia[1] that is less amenable to treatment than its two other core features: psychotic symptoms and negative symptoms.[2]

  • Because cognitive deficits in schizophrenia are of such clinical importance, it would be useful to detect them in a clinical setting

  • To the best of the authors’ knowledge, this was the first study to compare the scores of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Test (MoCA) in an Afrikaans-speaking population of schizophrenia patients

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Summary

Introduction

Cognitive impairment is a core feature of schizophrenia[1] that is less amenable to treatment than its two other core features: psychotic symptoms (especially) and negative symptoms.[2]. Cognitive impairment is a core feature of schizophrenia that has strong prognostic significance. In most clinical settings comprehensive neuropsychological testing to detect cognitive impairment in schizophrenia patients is not readily available, but because cognitive deficits in schizophrenia are clinically important it would be useful to detect or at least screen for them in a clinical setting. There are no validated, brief screening instruments for the detection of cognitive impairment in schizophrenia. The Montreal Cognitive Assessment Test (MoCA) and the Mini-Mental State Examination (MMSE) show promise in this regard. The objective of this study was to compare the results of the MMSE and MoCA in a group of outpatient schizophrenia sufferers to contribute to research into the instruments’ potential usefulness as screening tools for cognitive impairment in schizophrenia

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