Abstract
BackgroundSubjective cognitive complaints are prevalent in those affected by functional psychoses and a variety of possible associated factors have been investigated. However, few studies have examined these potential factors within single studies or analyses.MethodsPatients with a history of a schizophrenia spectrum disorder (n = 115) and a non-clinical comparison group (n = 45) completed the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) and the Brief Assessment of Cognition in Schizophrenia (BACS). The patient group also completed the Positive and Negative Syndromes Scale (PANSS), the Birchwood Insight Scale (IS), and the Hospital Anxiety and Depression Scale (HADS).ResultsThe BACS and SSTICS scores were associated in the non-clinical comparison group, but not in the patient group. In the patient group worse subjective cognition was associated positively with good insight, greater dysphoria and greater positive symptoms. Linear regression revealed that, once other variables had been accounted for, dysphoria (HADS anxiety and depression factor) was the only significant predictor of SSTICS scores.ConclusionsSubjective cognitive impairment in patients with psychosis in the absence of formal testing should not be taken as evidence of impaired cognitive functioning. Mood should be investigated when patients present with subjective cognitive complaints.
Highlights
Self-report of cognitive deficits in schizophrenia is potentially important
Clinical participants 115 patients, 84 male and 31 female, mean age = 36.0 years (SD = 11.59), who had been diagnosed by their consultant psychiatrists as suffering from a schizophrenia-spectrum disorder according to ICD-10 criteria, aged 16–65, with a sufficient level of English literacy to complete the measures and capacity to provide informed consent, were referred from clinical teams in the North West of England
Data for this latter variable were log transformed for use in the analyses reported below
Summary
Self-report of cognitive deficits in schizophrenia is potentially important. If patients can accurately report their own cognitive problems this should help in the planning of interventions related to functional outcome and individual therapy. Specific complaints are not mirrored on relevant specific tests of neuropsychological function This has been explained in terms of the lack of ecological validity of neuropsychological tests and patients misinterpreting terms such as ‘‘attention’’ and ‘‘memory’’. This raises the question as to what SCC represents and what factors are involved in its expression. Once neuropsychological performance and antipsychotic dose had been accounted for, would SCC be predicted in terms of symptoms related directly to psychosis, including insight? Subjective cognitive complaints are prevalent in those affected by functional psychoses and a variety of possible associated factors have been investigated. Few studies have examined these potential factors within single studies or analyses
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