Cognitive Assessment Interview Research Articles

Interview Versus Performance Assessment of Cognition as Predictors of Real-World Outcomes in a Large-Scale Cross-Sectional Study in Schizophrenia.

The Cognitive Assessment Interview (CAI) is an interview-based scale measuring cognitive impairment and its impact on functioning in subjects with schizophrenia (SCZ). It is approved as a coprimary measure of performance-based instruments, such as the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB). Recent research highlights negative symptoms, social cognition, and functional capacity as mediators of cognitive impairment's impact on functioning. This study compared mediation analysis outcomes using CAI or MCCB scores, providing insights into the utility of interview-based tools in research and clinical practice. The study included 618 individuals diagnosed with schizophrenia, recruited from 24 Italian psychiatric clinics. Neurocognitive assessments utilized both CAI and MCCB. Mediation analyses explored negative symptoms, social cognition, and functional capacity as mediators of the impact of neurocognition on real-life functioning domains. The study's results extend the validation of the CAI as a coprimary measure that provides valid information on the impact of cognitive impairment on real-life functioning and its possible mediators, complementing the information obtained using the MCCB. Interview-based cognitive assessment might be essential for understanding schizophrenia complexity and its impact on various cognitive and functional domains for clinicians, patients, and caregivers.

Schizophrenia and Nicotine - A Bittersweet Psychiatric Story

Abstract Background: Schizophrenia is a chronic mental disorder affecting mood, perception, and most importantly cognition. This severely interferes with the functioning of such patients. On the other hand, nicotine use (both smoke and smokeless tobacco) is very much prevalent in schizophrenic patients, much more than normal population. This study aims to find the relation between nicotine use and cognition in schizophrenic patients. Methodology: Fifty-six new patients diagnosed with schizophrenia of both sexes between ages 18 and 60 years, giving valid and informed consent, were selected for the study. Fagerstrom test for nicotine dependence was done and the patients were divided into two groups: scores 4 or less (low-to-moderate dependence) and scores 5 or more (severe dependence). The Cognitive Assessment Interview was performed. Then, an independent sample t-test was used to compare the scores on various cognitive domains between the two groups. Results: The cognitive scores were better in the group with severe tobacco dependence, both globally and across individual domains. These associations were statistically significant (P = 0.001). The mean difference was highest in the social cognition group. Among all the domains, the t-value was highest for the speed of processing domain, indicating that this particular cognitive domain has the best discriminative value when compared between two groups of nicotine users. Conclusions: Hence, to conclude, whether nicotine has indeed a beneficial effect on cognition in schizophrenia has to be investigated longitudinally so that a possible treatment option to address cognitive impairment in schizophrenia is obtained. Extensive longitudinal studies needs to be conducted to better understand the long-term effect of tobacco use and cognition in schizophrenia patients.

Cognitive intraindividual variability, cognitive impairment and psychosocial functioning in first-episode psychosis patients

Cognitive intraindividual variability (IIV) refers to fluctuations in performance across tasks (i.e. dispersion) or in a single task on multiple occasions (i.e. inconsistency). Little is known about IIV in patients with first-episode psychosis (FEP). We aimed to explore the association between IIV and both global cognitive performance and psychosocial functioning in a sample of 103 FEP patients.Patients were recruited at discharge from the PEPsNa program, a FEP follow-up intervention program lasting 24 months. The Social and Occupational Functioning Scale (SOFAS) and the Cognitive Assessment Interview (CAI-Sp) were employed for assessing psychosocial functioning. Cognitive assessments were performed using the MATRICS Cognitive Assessment Battery (MCCB), and the variability in the cognitive functions assessed with the MCCB was used to calculate the IIV.Significant correlations were obtained between IIV and global MCCB scores, the CAI-Sp and the SOFAS. We found significant differences in psychosocial functioning and cognitive performance between patients with high and low IIV. A higher IIV in FEP patients was related both to worse psychosocial functioning and worse global cognitive performance. Unlike global cognitive performance, IIV was not related to clinical characteristics, suggesting that it could be an indicator of cognitive impairment even in the absence of global impairment.

Introducing an interview-based cognitive assessment tool for people with Schizophrenia in Ethiopia

Assessment of cognitive impairment in people with schizophrenia (PWS) is limited in low and middle-income countries due to lack of context-appropriate measures. This study aimed to select, adapt, and evaluate an interview-based cognitive tool for PWS in Ethiopia. The study was carried out in three phases. In the first phase, we followed a rigorous instrument selection procedure to select a tool for adaptation. We then applied a rigorous instrument adaption procedure, including interviews with 24 participants. Finally, we evaluated the psychometric properties of the adapted tool with 208 PWS and 208 matched controls. The Cognitive Assessment Interview was selected as the appropriate tool for adaptation. This tool is practical and tolerable, with short time of administration. We reported high inter-rater reliability and test-retest reliability for the adapted scale. One-factor structure better represented the data with excellent internal consistency. Weak but significant correlation with a performance-based battery was reported. At a cut-off value of > 13, the tool significantly differentiated PWS from controls (62 % sensitivity and 82 % specificity). Item Response Theory-based analysis showed that the tool gives much information among severely impaired participants. The findings show that the tool is reliable, valid, and practical in resource-scarce settings.

Insight in cognitive impairment assessed with the Cognitive Assessment Interview in a large sample of patients with schizophrenia

The Cognitive Assessment Interview (CAI) is an interview-based scale measuring cognitive impairment and its impact on functioning in subjects with schizophrenia (SCZ). The present study aimed at assessing, in a large sample of SCZ (n = 601), the agreement between patients and their informants on CAI ratings, to explore patients’ insight in their cognitive deficits and its relationships with clinical and functional indices. Agreement between patient- and informant-based ratings was assessed by the Gwet’s agreement coefficient. Predictors of insight in cognitive deficits were explored by stepwise multiple regression analyses. Patients reported lower severity of cognitive impairment vs. informants. A substantial to almost perfect agreement was observed between patients’ and informants’ ratings. Lower insight in cognitive deficits was associated to greater severity of neurocognitive impairment and positive symptoms, lower severity of depressive symptoms, and older age. Worse real-life functioning was associated to lower insight in cognitive deficit, worse neurocognitive performance, and worse functional capacity. Our findings indicate that the CAI is a valid co-primary measure with the interview to patients providing a reliable assessment of their cognitive deficits. In the absence of informants with good knowledge of the subject, the interview to the patient may represent a valid alternative.

A CROSS-SECTIONAL STUDY ON IMPACT OF MEDICATIONS ON COGNITION IN PATIENTS WITH SCHIZOPHRENIA

Background: Cognitive decits in schizophrenia might start before onset of symptoms. Medications reduce the illness severity, but their effect on cognition is not clearly established. Poor cognition may worsen the prognosis and hence impact the overall functioning. To assess the effect Aim: of ongoing medications on cognition in patients with schizophrenia. A cross-sectiona Methods: l, observational study was conducted from JulyAugust, 2022 in a tertiary psychiatric hospital using convenience sampling in patients with schizophrenia on atleast 6-8weeks of same treatment medications. Patients with neurodevelopmental, neurological, neurodegenerative, chronic substance use or known personality disorders and drug naive patients were excluded. Brief Psychiatric Rating Scale was used to assess illness severity and Cognitive Assessment Interview was conducted to assess cognitive decit. 107 subjects(n=60;56.1% men and n=47;43.9% women) with Results: diagnosis of schizophrenia were considered; mean age being 35.8610.14 years, mean duration of illness being 8.015.62 years. Majority had mild cognitive impairment(n=50;46.7%). Pearson's correlation showed signicant positive correlation between cognitive functioning and olanzapine and uoxetine use(r= 0.195 and r=0.296 respectively; p <0.05). Signicant negative correlation was observed between cognitive functioning and trihexyphenidyl use(-0.195; p<0.05). Medications used in schizophrenia can have both benecial Conclusion: and deleterious effects on cognition. Further longitudinal studies on patients maintaining on the same medications will help to establish the association and hence their relative impact on cognition.

Comparison of the telephone-Montreal Cognitive Assessment (T-MoCA) and Telephone Interview for Cognitive Status (TICS) as screening tests for early Alzheimer's disease.

Remote screening for cognitive impairment associated with Alzheimer's disease (AD) has grown in importance with the expected rise in prevalence of AD in an aging population and with new potential treatment options. The Telephone Interview for Cognitive Status (TICS) and new telephone adaptation of the Montreal Cognitive Assessment (T-MoCA) were administered to participants independently classified through in-person clinical evaluation as cognitively normal (CN; n = 167), mild cognitive impairment (MCI; n = 25), or dementia (n = 23). Cerebrospinal fluid AD biomarkers were measured (n = 79). TICS and T-MoCA were highly correlated (r = 0.787; P <0.001): groups differed on both (CN<MCI<dementia; TICS: F [2212] = 156.66; P <0.001; T-MoCA: F [2210] = 143.72; P <0.001), both effectively detected cognitive impairment (receiver operating characteristic area under the curve: TICS = 0.889; T-MoCA = 0.902), and both negatively correlated with a composite AD biomarker (tau/amyloid beta 1-42; TICS: r = -0.372; P = 0.001; T-MoCA: r = -0.480; P <0.001). TICS and T-MoCA are effective for remotely detecting cognitive impairment associated with AD in older adults. Strong correlation between tests provides construct validity for the newer T-MoCA. Construct validity for the telephone adaptation of the Montreal Cognitive Assessment (T-MoCA) was newly established against the Telephone Interview for Cognitive Status (TICS). TICS and T-MoCA effectively detected cognitive impairment with remote administration. Both tests negatively correlated with a composite cerebrospinal fluid Alzheimer's disease (AD) biomarker (tau/amyloid beta 1-42).

Comparison of the Telephone‐Montreal Cognitive Assessment (T‐MoCA) and Telephone Interview for Cognitive Status (TICS) as Remote Screening Tests for Early Alzheimer’s Disease.

AbstractBackgroundThe number of Americans with Alzheimer’s disease (AD) is expected to rise to nearly 14 million by 2060. This alarming number shows a critical need for brief mental status tests that can be administered remotely (e.g., by telephone or videoconferencing) to large numbers of individuals while maintaining the ability to reliably detect cognitive impairment related to AD. Therefore, we sought to validate a recently developed, remotely administered cognitive screening measure, the T‐MoCA, against an established remote measure, the TICS, and prior in‐person clinical and cognitive assessment that provided clinical diagnosis. Relationships with CSF biomarkers of AD were also examined.MethodsThe TICS and T‐MoCA were completed approximately one‐week apart by 215 participants at the UCSD ADRC. Test order was partially counterbalanced. Extensive in‐person clinical and neuropsychological assessment had been completed on average 1.5 years prior and participants classified as cognitively normal (CN; n = 167), mild cognitive impairment (MCI; n = 25) or dementia (n = 23). CSF had been obtained from 79 participants within 48 months of remote testing and levels of Aβ 1–40 and 1–42, phosphorylated tau (p‐tau), and total tau were measured.ResultsTICS and T‐MoCA scores were highly correlated overall (r = .787;p&lt;.001), and moderately within specific MCI (r = .657;p&lt;.001) and dementia (r = .673,p = .001) groups (r = .309, p&lt;.001 for CN only). Groups differed significantly on TICS (F(2,212) = 156.66;p&lt;.001) and T‐MoCA (F(2,210) = 143.72;p&lt;.001), with dementia&lt;MCI&lt;NC on both (p’s&lt;.001). TICS and T‐MoCA had excellent ability to discriminate CN from cognitively impaired (i.e., MCI/dementia) with ROC areas under the curve of .889 and .902, respectively. Optimal cut‐off scores were &lt;17/22 for T‐MoCA (90.4% sensitivity, 76.6% specificity) and &lt;34/41 for TICS (91.0% sensitivity, 74.5% specificity). A composite CSF biomarker of AD (total tau/Aβ 1–42 ratio) was negatively correlated with TICS (r = ‐.372;p = .001) and T‐MoCA (r = ‐.480;p&lt;.001).ConclusionThe T‐MoCA and TICS are valid brief cognitive screening tests with remote administration that can distinguish individuals with cognitive impairment from those who are cognitively normal. The two tests have similar discriminative ability and degree of association with levels of AD biomarkers in CSF. Thus, the T‐MoCA and TICS are promising measures to meet the growing need for remote cognitive screening for AD.

Recognition and Assessment of Cognitive Impairment in Schizophrenia

A renewal of interest in the cognitive assessment of people with schizophrenia was related to the increasing acknowledgement of the strong relationships of cognitive deficits with functional outcome. In the early 2000’s, research focused on those aspects of cognition that demonstrated a strong correlation with a variety of functional outcome measures (community functioning, functional capacity, social skills acquisition). Later on, social cognition, which was not included in neuropsychological batteries, became also a focus as it represents a mediator of the impact of neurocognition on functioning. The renewed interest and the association with functional outcome stimulated the development of batteries specifically devoted to the cognitive assessment of subjects with schizophrenia. The MATRICS Consensus Cognitive Battery (MCCB) is the instruments with the largest evidence of good psychometric properties and strong relationship with functional outcome. The MCCB has been proposed as the gold standard in assessing cognitive impairment in subjects with schizophrenia and has been translated into 24 languages and validated in many different countries. Different instruments are also available to assess emotional processing and theory of mind which should complement MCCB and similar batteries. The long administration time limits the use of batteries in everyday clinical routine and short-administered instruments were developed as screening tools. A brief, interview-based assessment of cognitive functioning, the Cognitive Assessment Interview, has also been developed and validated for use in clinical settings or as a co-primary measure in clinical trials. The development of a guidance paper might promote the routine assessment of cognition in subjects with schizophrenia.DisclosureHonoraria, advisory board, or consulting fees from Angelini, Astra Zeneca, Bristol-Myers Squibb, Gedeon Richter Bulgaria, Innova-Pharma, Janssen Pharmaceuticals, Lundbeck, Otsuka, Pfizer, and Pierre Fabre, for services not related to this abstract

The Cognitive Assessment Interview (CAI): Association with neuropsychological scores and real-life functioning in a large sample of Italian subjects with schizophrenia

IntroductionThe Cognitive Assessment Interview (CAI) is an interview-based scale developed to measure cognitive impairment and its impact on functioning in subjects with schizophrenia (SCZ). Previous studies demonstrated good psychometric properties of the CAI. However, only relatively small samples of SCZ were investigated. This study aimed to determine in a large sample of SCZ (N = 580) the relationships of the Italian Version of the CAI with measures of cognitive performance and functional capacity and real-life functioning, using state-of-the-art instruments. MethodsIntraclass correlation coefficients (ICCs) and Cronbach's alpha were calculated to examine the CAI's inter-rater reliability and internal consistency. Pearson's correlation coefficients were used to evaluate relationships between CAI global and domain composite scores with neurocognition, social cognition, functional capacity, and functioning. ResultsThe inter-rater reliability and internal consistency were good to excellent. The CAI global composite score showed a strong correlation with the MATRICS Consensus Cognitive Battery (MCCB) composite score (r = −0.50) and moderate/strong associations with measures of functional capacity (−0.46 < r < −0.52) and real-life functioning (−0.30 < r < −0.51). Finally, CAI composite social cognition score correlated moderately with the Facial Emotion Identification Test (r = −0.31) and two subscales of the Awareness of Social Inference Test (−0.32 < r < −0.34). ConclusionsThe study suggests that CAI is a valid co-primary measure for clinical trials and a suitable instrument to screen impairment in neurocognitive and social cognitive domains and its impact on functioning in SCZ in everyday clinical practice.

An Interview-Based Assessment of the Experience of Cognitive Impairment in Multiple Sclerosis: The Cognitive Assessment Interview (CAI).

Background: Cognitive impairment is a common feature of multiple sclerosis (MS). A semi-structured interview, including informant input, can characterize the experience of individuals living with MS and cognitive involvement.Objective: We administered the Cognitive Assessment Interview (CAI), a patient- and informant-based semi-structured interview, to characterize the experience of cognitive impairments in those living with MS.Methods: Trained raters administered the CAI to a sample of MS participants and their informants enrolled for a trial of cognitive remediation. Cognitive impairments on the CAI were characterized and compared to those captured by neuropsychological and self-report measures.Results: A total of n = 109 MS participants (mean age = 50.3 ± 12.2) and their available informants (n = 71) were interviewed. Participants reported experiencing processing speed (90/106, 85%), working memory (87/109, 80%), and learning and memory (79/109, 72%) problems most commonly. CAI-based ratings were moderately correlated with a self-report measure (Multiple Sclerosis Neuropsychological Screening Questionnaire, rs = 0.52, p < 0.001) and only mildly correlated with objective neuropsychological measures specific to executive functions (rs = 0.21, p = 0.029). For those with informant interviews, ratings were overall consistent, suggesting that the CAI is valid even in cases in which an informant is unavailable and the interview is conducted with the patient alone (as is often the case in clinical and research settings).Conclusions: The CAI provides a semi-structured interview to characterize the experience of cognitive impairment in MS, with findings representing real-world functioning, adding valuable information to both self-report measures and neuropsychological assessment.

Ability of Older Adults to Report Elder Abuse: An Emergency Department-Based Cross-Sectional Study.

To characterize assessments of a patient's ability to report elder abuse within the context of an emergency department (ED)-based screen for elder abuse. Cross-sectional study in which participants were screened for elder abuse and neglect. Academic ED in the United States. Patients, aged 65 years and older, presenting to an ED for acute care were assessed by trained research assistants or nurses. All patients completed the four-item Abbreviated Mental Test 4 (AMT4), then completed a safety interview (using the Emergency Department Senior Abuse Identification tool) designed to detect multiple domains of elder abuse and received a physical examination. Based on the cognitive assessment and safety interview, assessors ranked their confidence in the patient's ability to report abuse as absolutely confident, confident, somewhat confident, or not confident. To assess interrater reliability, two assessors independently rated confidence for a subset of patients. Assessors suspected elder abuse in 18 of 276 patients (6.5%). Assessors were absolutely confident in the patient's ability to report abuse for 95.7% of patients, confident for 2.5%, somewhat confident for 1.5%, and not confident for 0.3%. Among patients with an AMT4 of 4 (n = 249), assessors were confident or absolutely confident in 100% of patients. Among patients with an AMT4 of less than 4 (n = 27), they were confident or absolutely confident in the patient's ability to report abuse for 81% of patients, including 11 of 12 patients with mild cognitive impairment and 7 of 11 patients with severe cognitive impairment. For patients receiving paired evaluations (n = 131), agreement between assessors regarding patient ability to report abuse was 97% (κ = 0.5). In this sample of older adults receiving care in an ED, research assistants and nurses felt that the vast majority were able to report elder abuse, including many patients with cognitive impairment. J Am Geriatr Soc 68:170-175, 2019.

Nicotine effects on cognitive remediation training outcome in people with schizophrenia: A pilot study

Cognitive remediation training can alleviate cognitive impairment associated with schizophrenia, but the impact is limited by small effect sizes. The present study aimed at augmenting training effects by administering nicotine prior to training sessions. Twenty-five people with schizophrenia were enrolled in a 10-week, 5 days/week, computerized cognitive training regimen. Participants were randomized to two treatment groups: nicotine or placebo. Every Monday and Thursday, the nicotine group received a nicotine lozenge before the training, and the placebo group a placebo lozenge. Outcome measurements were conducted on a no-lozenge day in weeks 0, 4, 7, and 10, and at 4-week follow-up. The MATRICS Consensus Cognitive Battery composite score improved over time, but there was no group difference in this effect. A significant group difference emerged over time in the reasoning/problem solving sub-domain: the placebo group improved but not the nicotine group, suggesting that nicotine exposure negatively impacted training benefits on executive control processes. There were no effects on psychiatric symptoms. However, significant improvements were seen across groups on the Quality of Life Scale and the Cognitive Assessment Interview, measuring real-life functional outcome. In conclusion, the present study failed to find evidence that nicotine exposure during cognitive remediation training may potentiate training benefits.

Virtual reality assessment of functional capacity in the early course of schizophrenia: Associations with cognitive performance and daily functioning.

Computer-based virtual reality assessments of functional capacity have shown promise as a reliable and valid way to assess individuals with multi-episode schizophrenia. However, there has been little research utilizing this innovative approach with young patients who are in the early phase of schizophrenia. Outpatients in the early course of schizophrenia (n = 42) were compared to controls (n = 13) at cross-sectional study points. Patients were within 2 years of their first psychotic episode, were an average of 22.2 years old and had an average of 12.3 years of education. We used the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) and the University of California, San Diego (UCSD) Performance-Based Skills Assessment-2 (UPSA-2) to assess functional capacity. The MATRICS Consensus Cognitive Battery (MCCB) and the Cognitive Assessment Interview (CAI) were the measures of cognitive functioning. The Global Functioning Scale: Role (GFS-R) and Social (GFS-S), and the Role Functioning Scale (RFS) were the measures of daily functioning. Early course patients vs controls were slower (patient M = 830.41 seconds vs control M = 716.84 seconds; t = 3.0, P < .01) and committed more errors (patient M = 3.2 vs control M = 1.7 seconds, t = 2.9, P < .01) on the VRFCAT. Total time was significantly correlated with the UPSA (r = -0.66, P < .01), MCCB (r = -0.70, P < .01), CAI (r = -0.51, P < .01), and GFS role (r = -0.52, P <. 01) and social functioning (r = -0.43, P = .03). We extend previous findings to patients with first-episode schizophrenia. Virtual-reality-based performance was correlated with a standard test of functional capacity, indicating VRFCAT validity. Furthermore, correlations with cognitive functioning and occupational/school and social functioning indicate promise as a co-primary measure to track changes in response to treatment.

Evaluation of a plasticity-based cognitive training program in schizophrenia: Results from the eCaesar trial

ObjectiveCognitive impairment in schizophrenia is a core feature of the disorder. Computerized cognitive training has shown promise in pilot studies. A 26-week randomized blinded placebo-controlled trial was conducted to investigate the effect of a novel computerized cognitive training program on cognitive and functional capacity outcomes. MethodThe study followed MATRICS guidelines for the evaluation of interventions designed to improve cognitive function in schizophrenia. Participants (N = 150) were randomized to experimental (computerized cognitive training in a game-like format) or active control (computer games) groups. Training was conducted in-clinic, with an intended training schedule of 5 days per week, 1 h per day, for 26 weeks. Co-primary outcome measures were the MATRICS Consensus Cognitive Battery (MCCB) composite score and the UCSD Performance-Based Skills Assessment (UPSA-2) total score, secondary outcome measures included the Cognitive Assessment Interview (CAI) and the Short-Form-12 Mental Composite Score (SF-12 MCS). Target engagement was assessed with task-learning based assessment. ResultsAt baseline, the groups were well matched. No significant effect of the experimental treatment was seen on the primary or secondary outcome measures compared to the active control. Review of the task learning/target engagement data suggested inadequate target engagement. ConclusionsResults do not support a cognitive or functional capacity benefit from this implementation of a computerized cognitive training program in people with schizophrenia. In future trials, careful consideration is merited of the assessment of task learning/target engagement, the effects of making the cognitive training game-like on motivation, and the implicit effects of trial requirements on participant selection.

Depressive Temperament in Relatives of Patients with Schizophrenia Is Associated with Suicidality in Patients with Schizophrenia.

ObjectiveSuicide is a major cause of death in patients with schizophrenia; thus, predicting and preventing suicide in patients with schizophrenia is examined in various studies. Affective temperaments which are accepted as precursors of mood disorders may be an important factor in predicting suicidality. This study investigated the relationship between affective temperaments of relatives of schizophrenia patients and suicidal thoughts and other clinical correlates of patients with schizophrenia.MethodsPatients with schizophrenia and their first degree relatives are included to the study. All of the participants were evaluated with Structured Clinical Interview for DSM-IV axis I disorders and relatives with active psychiatric diagnosis were excluded. Positive and Negative Symptom Scale, Clinical Global Impression Scale, Turkish version of cognitive assessment interview were administered congruently to the patients. Relatives of the patients were evaluated with Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Auto-questionnaire.ResultsDepressive temperament scores of relatives of schizophrenic patients who had suicidal thoughts were higher than the scores of the relatives of the patients who did not have suicidal thoughts. Depressive temperament also predicted number of suicide attempts in regression analysis. Number of suicide attempts was also related with number of hospitalization and functionality of the patient.ConclusionSuicidality in schizophrenia is related with relatives’ affective temperaments and patients’ own positive symptom scores. The relationship between suicidal thoughts and depressive temperament is high lightened in this study

The Effect of Psychosocial Skills Training and Metacognitive Training on Social and Cognitive Functioning in Schizophrenia.

The aim of this study is to investigate the effects of Psychosocial Skills Training (PSST) and Metacognitive Training (MCT) programs on general psychopathology, cognitive functioning, and social functioning in patients with schizophrenia. Twenty patients with schizophrenia who were treated at the Kocaeli University Psychiatry Department outpatient clinic between January and June 2016, accepted to participate in the study and met inclusion criteria were included in this study. Patients were randomized as two groups of 10 people. The management of each group was carried out by a trainer and a co-trainer. The Positive and Negative Symptom Scale (PANSS) and Clinical Global Impression Scale-Severity (CGI-S) to assess psychopathology, the General Assessment of Functioning (GAF) and the Quality of Life Scale in Schizophrenia (QoLS) to assess social functioning, the Cognitive Assessment Interview (CAI) to assess cognitive functioning were used by the clinicians blinding to groups in the first two weeks before and after the intervention. After the training, first and last test scale scores were compared. All patients who participated in the study completed the study (male: 13, female: 7). There was no significant difference in age, gender, marital status, years of education, duration of illness, the age of onset, and the number of hospitalizations in comparison of individual and clinical characteristics of the groups (p>0.05). When the scores were compared of the groups before and after the intervention, there was a significant difference concerning psychopathology, social and cognitive functioning in both groups (p<0.05). There were no significant differences between the groups in terms of effect size. The study showed that both programs aiming to improve psychopathology and functioning in the treatment of schizophrenia have positive results. Improvement in cognitive functioning should also be tested by neurocognitive tests in the large-scale studies with control groups.

Associations of fatty acids with cognition, psychopathology, and brain-derived neurotrophic factor levels in patients with first-episode schizophrenia and related disorders treated with paliperidone extended release

This study assessed fatty acid and brain-derived neurotrophic factor levels in patients with first-episode schizophrenia and related disorders. The levels of erythrocyte fatty acids and plasma brain-derived neurotrophic factor were measured at baseline and week 8 after treatment with paliperidone extended release. Cognitive function was evaluated using the Cognitive Assessment Interview and the cognition subscale of the Neuroleptic-Induced Deficit Syndrome Scale. There were significant decreases in stearic acid and nervonic acid levels and a significant increase in eicosapentaenoic acid levels after eight weeks. At week 8, cognition was positively associated with dihomo-γ-linolenic acid, linoleic acid, and eicosapentaenoic acid levels, and negatively associated with nervonic acid levels. Psychopathology was positively correlated with polyunsaturated fatty acid levels, and negatively correlated with saturated fatty acid levels at week 8. At both baseline and week 8, brain-derived neurotrophic factor level had a negative association with polyunsaturated fatty acids and a positive association with saturated fatty acids and monounsaturated fatty acids. The present study demonstrated that fatty acids have significant associations with cognition and psychopathology at week 8, and with brain-derived neurotrophic factor levels at both baseline and week 8.

Abstract TP439: Occurrence (Incidence and Prevalence) Rate of Delirium and Risk Factors in Acute Stroke - Cross-sectional Study

Introduction: Guidelines recommend screening all stroke admissions for cognitive impairment. Delirium may be an important contributor to cognitive problems, but available data are limited by potential selection biases and imperfect delirium assessment. We aimed to describe robust estimates of delirium occurrence (incidence and prevalence) and risk factors in an acute stroke unit (ASU). Methods: We collected data from sequential admissions to our University Hospital ASU over a 20 week period (Feb-July 2016). The only exclusion was where the clinical team felt that any form of assessment was inappropriate. We aimed to perform cognitive assessments at 48 hours post stroke. Cognitive assessments were based on mini Montreal Cognitive Assessment (m-MoCA) and GP-Cog informant interview to assess for pre-stroke dementia. We assessed for delirium based on DSM-V criteria. We described univariable and multivariable associations with delirium occurrence. Results: Across the study period, 184 strokes were admitted; median age 71 years (IQR:61-79). Some form of cognitive assessment was available for 178 (97%). In total. 152 had evidence of cognitive impairment on m-MOCA, 55 (31%) met criteria for delirium and 25 (15%) had pre-stroke dementia. Significant univariable associations with delirium were:age and pre-existing cognitive decline. On logistic regression:age, history of drug or alcohol misuse and pre-stroke mRS were all independently associated with delirium. Discussion: In an unselected ASU population a substantial proportion will have cognitive impairment based on screening. Delirium is common and contributes to this cognitive problems seen in acute stroke. Independent associations with delirium occurrence were identified but were non-modifiable. Our results have implications for policy and practice. As post-stroke cognitive impairment is multifactorial, screening delirium and pre-existing cognitive issues should form part of the initial assessment.

The Cognitive Assessment Interview: A comparative study in first episode and chronic patients with psychosis

The Cognitive Assessment Interview (CAI) is an interview-based instrument to assess cognition considering the impact of cognitive impairment on daily activities. We aimed to explore the associations of the Spanish version of the CAI (CAI-Sp) with a neuropsychological battery and a measure of psychosocial functioning in psychosis. The sample consisted of fifty-six first episode psychosis (FEP) patients and 66 non-FEP patients, who were assessed with a neuropsychological battery, the CAI-Sp and the Short Disability Schedule (DAS-S). Patients also underwent clinical assessment. Additionally, 37 controls were assessed with the neuropsychological battery and CAI-Sp, for normalization purposes. The results showed that CAI-Sp scores were overall correlated with the neuropsychological battery in non-FEP patients. In FEP patients, we found fewer significant correlations. Most associations were maintained after controlling for clinical symptoms. CAI-Sp rater scores contributed to the variance in the DAS-S scores in both groups, as did negative and disorganized symptoms. The CAI-Sp may be a good instrument to assess cognition in non-FEP patients. In FEP patients, it was less effective in capturing cognitive impairments and their functional consequences, probably because cognitive deficits have yet to become evident, due to the recency of illness onset, and no functional disturbances were observed due to these cognitive impairments.