The screen for cognitive impairment in psychiatry (SCIP) as a routinely applied screening tool: pathology of acute psychiatric inpatients and cluster analysis

Petra Schmid,Tilman Steinert,Agata Czekaj,Scot E Purdon,Jürgen Frick,Carmen Uhlmann

doi:10.1186/s12888-021-03508-4

Abstract

BackgroundCognitive dysfunction has been reported in acute psychiatric patients for a long time. The detection of cognitive deficits is crucial both for clinical treatment and for predicting the psychosocial functional level in the further course of the disease. The SCIP is a well-evaluated screening instrument for the examination of cognitive performance in psychiatric patients. We recently integrated the SCIP into our routine admission and discharge assessments on two inpatient wards, and we examined the cognitive profiles of patients with psychotic and affective disorders over the course of their admission.MethodsShortly after admission, and prior to discharge, patients were routinely referred for examination with the SCIP. A total of 529 assessments were completed on admission, and 227 returned for SCIP at the time of discharge. After standardization of the test results against a normative sample, we examined the normalized test values in terms of percentages of pathological cognitive performance based on the total SCIP score, and each of the SCIP subscale scores. We conducted cluster analysis to identify cognitive subgroups within the clinical sample.ResultsMore than 70% of the SCIP results on admission were pathological. At discharge, improvements were observed, especially on tests with attention and speed components. Cluster analysis identified two groups. The cluster with chronic patients showed poorer results at admission, but greater improvement and reached the level of the others at discharge.ConclusionsThe SCIP appears to have value in routine diagnostic assessments, and in the quantification of improvements in cognitive performance during an inpatient stay. The greatest benefit was observed in chronically ill patients with many previous stays.Trial registrationDRKS00019825 (retrospectively registered on 03.12.2019).

Highlights

Cognitive dysfunction has been reported in acute psychiatric patients for a long time
We examined whether different clusters could be found based on the cognitive performance profiles
The most common primary diagnosis (82.4%) was a psychotic disorder (F2 ICD-10), and only 17.6% (n = 93) of the sample were diagnosed with an affective disorder (F3 ICD10)

Summary

Introduction

Cognitive dysfunction has been reported in acute psychiatric patients for a long time. We recently integrated the SCIP into our routine admission and discharge assessments on two inpatient wards, and we examined the cognitive profiles of patients with psychotic and affective disorders over the course of their admission. A meta-analysis of patients with psychotic disorders showed deficits in all cognitive areas, especially in the domains of verbal memory and processing speed [3]. Comparing the cognitive performance of patients with psychosis and affective disorders, no differences were found [8,9,10,11]. This is in contrast to the results of Bonner-Jackson et al [12]. Inconsistent findings were reported on the stability of the described deficits over the course of relatively brief inpatient treatment, with some reports of no improvement in cognitive deficits between admission and discharge [9, 13], and other reports of demonstrated improvements [10]

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