Abstract
BackgroundPatients 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.MethodsCross-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.ResultsA 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).ConclusionA 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.
Highlights
Patients with schizophrenia have a low level of insight into their illness compared to people with other mental health disorders
In conclusion, our results suggest that a significant proportion of patients with schizophrenia can estimate their cognitive impairment, independent from their level of insight, as a correlation was found between the objective cognitive measures and the subjective cognitive test
A positive correlation was found between depression and Subjective cognitive complaints (SCC), suggesting that this aspect should be investigated along with the clinical symptoms when a patient with schizophrenia presents with SCC
Summary
Patients with schizophrenia have a low level of insight into their illness compared to people with other mental health disorders [1]. This aspect of insight, termed neurocognitive insight, is described as the “awareness of neuropsychological dysfunction” [2]. Hamilton had demonstrated that self-rated memory questionnaires provided to healthy subjects have no relation to actual memory capability in the general population [12] It seems that lack of insight into cognitive deficits is not just a specific aspect in patients with schizophrenia
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