A Systematic Review of Brief Neuropsychological Tests in Use Among Patients With Psychotic Disorders in Low and Middle Income Countries.

Abstract

Introduction: Assessment of cognitive impairment is recommended as part of the comprehensive care of psychotic disorders. Brief neuropsychological assessments are particularly needed in low resource settings, but few reviews have focused on work done in this context. We aimed to undertake a systematic review of work done in low- and middle-income countries on brief neuropsychological assessments of cognitive impairment in psychotic disorders. Method: A systematic review was performed following PRISMA guidelines. We searched PubMed, Embase and PsycINFO for articles in which a brief neuropsychological test was used to assess cognitive impairment in patients with psychotic disorders in a low- and middle- income country (LMIC) context. Data on whether tests had been validated against the gold standard was abstracted. Data was also abstracted on the tests used, the domains assessed, personnel performing the tests, duration of tests and were abstracted. Results: A total of 29 articles met the inclusion criteria; these studied 3,184 participants with psychosis and 1,261 controls. No test was validated against a gold standard such as the MATRICS consensus cognitive battery. There was marked variability in the tests used, but most were delivered using pen and paper and assessed for cognitive impairment in the reasoning and problem solving domain. All but two publications used highly skilled personnel to perform the assessments.Conclusion: Although a few studies have focused on neuropsychological assessment of cognitive impairment in psychotic disorders in the LMIC context, none compared a brief neuropsychological test with a gold standard. Further work is therefore needed to determine the validity of brief neuropsychological assessment of cognitive impairment in psychotic disorders in these settings.

Aspects of Clinical Neuropsychology Related to the Psychotic Spectrum. A Comprehensive Systematic Review

“…These modifications may contribute to the cognitive impairments observed in patients with these disorders. Additional research is required to enhance our understanding of the underlying neurobiological mechanisms and to develop targeted therapeutic interventions for cognitive impairments in psychotic disorders [5][6][7]10].…”

“…Moreover, the evaluation of cognitive impairment in individuals with psychotic disorders extends beyond nations with high economic status. The demand for concise neuropsychological assessments is increasing in low and middle-income countries, where resource constraints are prevalent [6]. The same researchers conducted studies to investigate the efficacy of brief neuropsychological tests in evaluating cognitive impairment in individuals with psychotic illnesses within specific contexts.…”

“…In summary, clinical neuropsychology is vital in comprehending the cognitive deficits linked to psychotic spectrum disorders. Numerous studies have demonstrated that patients diagnosed with Schizophrenia and other psychotic disorders manifest diverse cognitive impairments spanning various areas [4][5][6][7]. Neuropsychological tests have a crucial role in the identification of distinct cognitive deficits and the prediction of psychosis [2].…”

Integrating Clinical Neuropsychology and Psychotic Spectrum Disorders: A Systematic Analysis of Cognitive Dynamics, Interventions, and Underlying Mechanisms

“…These changes may cause cognitive impairments in these disorders. More research is needed to understand neurobiological mechanisms and develop targeted psychotic disorder cognitive impairment treatments [5][6][7]10]. Schizophrenia and other psychotic spectrum disorders have many cognitive impairments that affect many aspects of cognitive functioning.…”

“…Historically, auditory or visual hallucinations and paranoid or grandiose delusions were the main focus of mental illness. However, recent neuropsychological advances have focused on these conditions' cognitive impairments [5][6][7]. The deficiencies mentioned above often determine an individual's functional capacity and quality of life, sometimes overshadowing psychotic symptoms [8][9][10].…”