Application of the Audio Recorded Cognitive Screen and its relation to functioning in schizophrenia

Brooke M Gelder,Vaughan J Carr,Carmel M Loughland,Peter W Schofield

doi:10.1017/neu.2015.19

Abstract

This study investigated the ability of the Audio Recorded Cognitive Screen (ARCS) to detect cognitive deficit in individuals with schizophrenia, relative to the Mini Mental State Examination (MMSE) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and explored the associations between the ARCS and functional outcomes. We hypothesised that the ARCS would be able to better discriminate between individuals with schizophrenia and healthy controls than the MMSE, and that ARCS performance would be correlated with measures of social and vocational functioning. The participants were 19 community-dwelling individuals with schizophrenia or schizoaffective disorder and 19 healthy controls recruited from the Australian Schizophrenia Research Bank (ASRB). Participants completed the ARCS, MMSE, and self-report measures of social and vocational functioning. Clinical and diagnostic data stored by the ASRB were also utilised. The schizophrenia group performed worse than the control group on the ARCS, with memory, t(36)=2.49, p=0.02, 95% CI [-1.84, -18.79] and fluency, t(36)=2.40, p=0.02, 95% CI [-1.87, -22.24] domains being the main discriminating measures. The RBANS also discriminated between the two groups, and ARCS and RBANS total scores were moderately to strongly correlated. There was no difference between the two groups on the MMSE after controlling for demographic variables. ARCS performance was associated with employment status [χ2(1)=7.16, p=0.007]. The ARCS may be sensitive to the cognitive deficits in outpatients with schizophrenia and an indicator of functional outcomes in this population.

Highlights

Cognitive impairment in individuals with schizophrenia is a well-established finding
These findings suggest that cognitive impairment is a predictor of functional outcomes in individuals with schizophrenia and should be viewed as an important assessment and treatment target if the overall level of disability is to be reduced [16]
Some of the ARCS scores were positively correlated with scores on the Global Assessment of Functioning in the psychosis group [26]. These findings suggest that the ARCS is sensitive to the cognitive deficits associated with psychosis and compares well with another wellstandardised measure

Summary

Introduction

Cognitive impairment in individuals with schizophrenia is a well-established finding. Cognitive deficits in schizophrenia have been shown to be associated with independent living skills [12], social functioning [13], and employment status [14,15]. These findings suggest that cognitive impairment is a predictor of functional outcomes in individuals with schizophrenia and should be viewed as an important assessment and treatment target if the overall level of disability is to be reduced [16]. Comprehensive neuropsychological test batteries represent the gold standard in cognitive assessment in schizophrenia Such batteries may be problematic in clinical settings because of the time, cost, and specialist training required. Research suggests that the MMSE may not be sensitive enough to detect cognitive deficit associated with schizophrenia [23,24]

Methods

Results

Conclusion