A snapshot of cognitive functioning: Deriving a tool for the efficient assessment of cognition in schizophrenia and other chronic psychiatric disorders in a real-world inpatient setting

Wong, Quincy J. J.; Miller, Marta; Fiorito, Ann; Ireland, Juelyn

doi:10.1016/j.psychres.2013.07.006

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…Various studies have identified subtests, such as symbol coding and fluencies, along with tests that have components such as processing speed , to be valid and efficient indicators of overall cognitive functioning using different patient groups ( Hurford et al, 2011 , Wong et al, 2013 ). With regard to functional outcome, recently Fervaha et al (2014) using data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study, concluded that the subtests of working memory and information processing speed (Letter Sequencing and Digit-Symbol Coding, respectively) were a valid estimate of overall cognitive status and had a similar relationship to clinical and functional outcomes, as in this administration of the full EPICOG-SCH battery.…”

Section: Discussionmentioning

confidence: 99%

“…The EPICOG-SCH cognitive battery subtests allowed us to differentiate among patients according to their overall functional status, their employment status and ongoing training activities. For schizophrenia, short batteries of tests have been shown to have a good correlation with the more thorough long batteries of tests (between 0.56 and 0.77) ( Wong et al, 2013 ). This level of efficiency is significant in clinical situations in which available time for assessment is limited.…”

Section: Discussionmentioning

confidence: 99%

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Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia

Domingo

Bobes

García-Portilla

et al. 2015

Schizophrenia Research: Cognition

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Background–objectivePrevalence data of cognitive impairment in Schizophrenia based on large population samples are scarce. Our goal is to relate cognition and functional outcomes, and estimate prevalence of cognitive impairment in a large sample of schizophrenia outpatients treated with second-generation antipsychotics.MethodA cross-sectional outpatient evaluation conducted during follow-up visits. Selection criteria included six-months stable treatment. The brief battery, EPICOG-SCH, covered four cognitive domains related to functional outcomes: working memory (WAIS-III-Letter-Number-Sequencing), executive function (Category Fluency Test; CFT), verbal memory (WMS-III-Logical-Memory), and information processing speed (Digit-Symbol-Coding and CFT). Clinical severity and functional impairment were assessed with CGI-SCH and WHO DAS-S. Impairment prevalence was calculated at ≤ 1.5 SD.ResultsAmong patients recruited (n = 848) in 234 participating centers, 672 were under 6-month treatment. 61.5% (n = 413) reported cognitive impairment according to CGI-SCH Cognitive Subscale. Estimated prevalences were 85.9% (95% CI 85.6–86.2%) CFT-Fruits; 68.3% (95% CI 67.8–68.8%) CFT-Animals; 38.1% (95% CI 37.5–38.3%) Digit-Symbol-Coding; 24.8% (95% CI 24.1–25.5%) Verbal Memory-Units; 20.9% (95% CI 20.2–21.6%) Letter-Number Sequencing; 11.7% (95% CI 11.0–12.4%) Verbal Memory-Items. Negative and Depressive symptoms, Deficit Syndrome, and functional disability were related to poor performance. Functional disability was predicted by CGI-SCH-Overall severity (OR = 1.34635, p < 0.0001), CGI-SCH-Negative Symptoms (OR = 0.75540, p < 0.0001), working memory (Letter-Number-Sequencing) (OR = − 0.16442, p = 0.0004) and the time-course (OR = 0.05083, p = 0.0094), explaining 47% of the observed variability.ConclusionMost prevalent impairments were on executive function and processing speed domains; however, working memory showed the strongest relationship to functional disability. Monitoring cognitive function during follow up is critical to understand patient’s everyday functional capacity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia

Domingo

Bobes

García-Portilla

et al. 2015

Schizophrenia Research: Cognition

View full text Add to dashboard Cite

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“…Results from this dataset have been presented elsewhere for a separate study [16]. To attain the largest dataset possible for the current study, only two inclusion criteria were applied (see Fig.…”

Section: Participantsmentioning

confidence: 99%

Broad spectrum psychiatric comorbidity is associated with better executive functioning in an inpatient sample of individuals with schizophrenia

Wong

Miller²

2015

Comprehensive Psychiatry

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“…Based on studies with different patient groups and different strategies of analysis, the processing speed and, more recently, working memory domains have been recognized as valid and efficient indicators of overall cognitive functioning in schizophrenia that are also related to functional outcomes (Hurford et al, 2011, Wong et al, 2013, Fervaha et al, 2014a, Kern et al, 2011). In these published studies, subtests such as letter sequencing (LNS), digit-symbol coding (DSC) and category fluencies subtest CFT) were identified as key subtests to be used in schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

EPICOG-SCH: A brief battery to screen cognitive impact of schizophrenia in stable outpatients

Domingo

Bobes

García-Portilla

et al. 2017

Schizophrenia Research: Cognition

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Brief batteries in schizophrenia, are needed to screen for the cognitive impact of schizophrenia. We aimed to validate and co-norm the Epidemiological Study of Cognitive Impairment in Schizophrenia (EPICOG-SCH) derived brief cognitive battery. A cross-sectional outpatient evaluation was conducted of six-hundred-seventy-two patients recruited from 234 centers. The brief battery included well-known subtests available worldwide that cover cognitive domains related to functional outcomes: WAIS-III-Letter-Number-Sequencing-LNS, Category Fluency Test-CFT, Logical-Memory Immediate Recall-LM, and Digit-Symbol-Coding-DSC. CGI-SCH Severity and WHO-DAS-S were used to assess clinical severity and functional impairment, respectively. Unit Composite Score (UCS) and functional regression-weighted Composite Scores (FWCS) were obtained; discriminant properties of FWCS to identify patients with different levels of functional disability were analyzed using receiver-operating characteristic (ROC) technique. The battery showed good internal consistency, Cronbach's alpha = 0.78. The differences between cognitive performance across CGI-SCH severity level subscales ranged from 0.5 to 1 SD. Discriminant capacity of the battery in identifying patients with up to moderate disability levels showed fair discriminant accuracy with areas under the curve (AUC) > 0.70, p < 0.0001. An FWCS mean cut-off score ≥ 100 showed likelihood ratios (LR) up to 4.7, with an LR + of 2.3 and a LR − of 0.5. An FWCS cut-off ≥ 96 provided the best balance between sensitivity (0.74) and specificity (0.62).The EPICOG-SCH proved to be a useful brief tool to screen for the cognitive impact of schizophrenia, and its regression-weighted Composite Score was an efficient complement to clinical interviews for confirming patients' potential functional outcomes and can be useful for monitoring cognition during routine outpatient follow-up visits.

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A snapshot of cognitive functioning: Deriving a tool for the efficient assessment of cognition in schizophrenia and other chronic psychiatric disorders in a real-world inpatient setting

Cited by 5 publications

References 22 publications

Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia

Cognitive Performance associated to functional outcomes in stable outpatients with schizophrenia

Broad spectrum psychiatric comorbidity is associated with better executive functioning in an inpatient sample of individuals with schizophrenia

EPICOG-SCH: A brief battery to screen cognitive impact of schizophrenia in stable outpatients

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