Impaired meaning-based cognitive skills are specifically associated with poorer subjective quality of life in schizophrenia

Tan, Eric J.; Rossell, Susan L.; Lee, Stuart

doi:10.1016/j.pmip.2020.100062

Cited by 5 publications

(7 citation statements)

References 43 publications

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“…A recent study by Kim et al (2021) demonstrated significant correlations between the WHODAS 2.0 and social cognition, such as communication and learning abilities (Kim et al 2021). Similarly, Tan, Rossell, and Lee (2020) demonstrated that mostly verbal-linguistic cognitive skills such as semantics and language are associated with subjective measures of functioning and wellbeing, as those have a direct effect on community functioning (Tan et al 2020). Indeed, medium to large associations between social cognition and community functioning have been reported in a meta-analysis (Fett et al 2011), whereas only small to moderate associations have been reported between nonsocial cognition and functional outcome (Halverson et al 2019).…”

Section: Discussionmentioning

confidence: 91%

“… 2021 ). Similarly, Tan, Rossell, and Lee ( 2020 ) demonstrated that mostly verbal-linguistic cognitive skills such as semantics and language are associated with subjective measures of functioning and wellbeing, as those have a direct effect on community functioning (Tan et al . 2020 ).…”

Section: Discussionmentioning

confidence: 96%

“…Similarly, Tan, Rossell, and Lee ( 2020 ) demonstrated that mostly verbal-linguistic cognitive skills such as semantics and language are associated with subjective measures of functioning and wellbeing, as those have a direct effect on community functioning (Tan et al . 2020 ). Indeed, medium to large associations between social cognition and community functioning have been reported in a meta-analysis (Fett et al .…”

Section: Discussionmentioning

confidence: 96%

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Longitudinal clinical and functional outcome in distinct cognitive subgroups of first-episode psychosis: a cluster analysis

et al. 2021

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Background Cognitive deficits may be characteristic for only a subgroup of first-episode psychosis (FEP) and the link with clinical and functional outcomes is less profound than previously thought. This study aimed to identify cognitive subgroups in a large sample of FEP using a clustering approach with healthy controls as a reference group, subsequently linking cognitive subgroups to clinical and functional outcomes. Methods 204 FEP patients were included. Hierarchical cluster analysis was performed using baseline brief assessment of cognition in schizophrenia (BACS). Cognitive subgroups were compared to 40 controls and linked to longitudinal clinical and functional outcomes (PANSS, GAF, self-reported WHODAS 2.0) up to 12-month follow-up. Results Three distinct cognitive clusters emerged: relative to controls, we found one cluster with preserved cognition (n = 76), one moderately impaired cluster (n = 74) and one severely impaired cluster (n = 54). Patients with severely impaired cognition had more severe clinical symptoms at baseline, 6- and 12-month follow-up as compared to patients with preserved cognition. General functioning (GAF) in the severely impaired cluster was significantly lower than in those with preserved cognition at baseline and showed trend-level effects at 6- and 12-month follow-up. No significant differences in self-reported functional outcome (WHODAS 2.0) were present. Conclusions Current results demonstrate the existence of three distinct cognitive subgroups, corresponding with clinical outcome at baseline, 6- and 12-month follow-up. Importantly, the cognitively preserved subgroup was larger than the severely impaired group. Early identification of discrete cognitive profiles can offer valuable information about the clinical outcome but may not be relevant in predicting self-reported functional outcomes.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

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Longitudinal clinical and functional outcome in distinct cognitive subgroups of first-episode psychosis: a cluster analysis

et al. 2021

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“…4,5 Neurocognitive impairments also significantly impact daily functioning, including functional capacity (i.e., the ability to perform skills in optimal conditions) and real-world functioning (i.e., completing day-to-day activities), 6,7 and quality of life. 8,9…”

Section: Introductionmentioning

confidence: 99%

Factors Impacting Access and Engagement of Cognitive Remediation Therapy for People with Schizophrenia: A Systematic Review

2022

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Objectives Neurocognitive deficits are central in schizophrenia. Cognitive remediation has proven effective in alleviating these deficits, with medium effect sizes. However, sizeable attrition rates are reported, with the reasons still uncertain. Furthermore, cognitive remediation is not part of routine mental health care. We conducted a systematic review to investigate factors that influence access and engagement of cognitive remediation in schizophrenia. Methods We systematically searched the PubMed, Web of Science, and PsycINFO databases for peer-reviewed articles including a cognitive remediation arm, access, and engagement data, and participants with schizophrenia spectrum disorders aged 17–65 years old. Duplicates and studies without a distinct cognitive remediation component, protocol papers, single case studies, case series, and reviews/meta-analyses were excluded. Results We included 67 studies that reported data on access and engagement, and extracted quantitative and qualitative data. Access data were limited, with most interventions delivered on-site, to outpatients, and in middle- to high-income countries. We found a median dropout rate of 14.29%. Only a small number of studies explored differences between dropouts and completers ( n = 5), and engagement factors ( n = 13). Dropouts had higher negative symptomatology and baseline self-efficacy, and lower baseline neurocognitive functioning and intrinsic motivation compared to completers. The engagement was positively associated with intrinsic motivation, self-efficacy, perceived usefulness, educational level, premorbid intelligence quotient, baseline neurocognitive functioning, some neurocognitive outcomes, and therapeutic alliance; and negatively associated with subjective cognitive complaints. Qualitative results showed good acceptability of cognitive remediation, with some areas for improvement. Conclusions Overall, access and engagement results are scarce and heterogeneous. Further investigations of cognitive remediation for inpatients, as well as remote delivery, are needed. Future clinical trials should systematically explore attrition and related factors. Determining influential factors of access and engagement will help improve the implementation and efficacy of cognitive remediation, and thus the recovery of people with schizophrenia.

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“…Cognitive impairments are a central aspect of schizophrenia spectrum disorders and have been repeatedly linked to poorer functioning and quality of life among patients (Green, 2016; Tan, Rossell, & Lee, 2020b; Tan, Thomas, & Rossell, 2014; Tolman & Kurtz, 2012). More recently, there is growing recognition that cognitive impairment severity varies among patients, ranging from broad deficits to performance at levels similar to healthy samples.…”

Section: Introductionmentioning

confidence: 99%

Cognitive heterogeneity in first-episode psychosis and its relationship with premorbid developmental adjustment

et al. 2021

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Background Patients with schizophrenia spectrum disorders have been increasingly recognised to form cognitive subgroups with differential levels of impairment. Using cluster analytical techniques, this study sought to identify cognitive clusters in a sample of first-episode psychosis (FEP) patients and examine clinical and developmental differences across the resultant groups. Methods In total, 105 FEP patients in the University of California Los Angeles Aftercare Research Program were assessed for cognition, symptoms and premorbid developmental adjustment. Hierarchical cluster analysis with Ward's method and squared Euclidean distance was conducted, confirmed by discriminant function analysis and optimised with k-means clustering. The stability of the solution was evaluated through split-sample (random, 80 and 70% samples) and alternate method (average linkage method) replication via Cohen's κ analysis. Controlling for multiple comparisons, one-way analysis of variances examined group differences in symptom severity and premorbid adjustment. Results Three groups were identified: severely impaired (n = 27), moderately impaired (n = 41) and relatively intact (n = 37). There were no significant differences in symptom severity across the groups. Significant differences were observed for scholastic performance at three different developmental stages: childhood, early adolescence and late adolescence, with the relatively intact group demonstrating significantly better scholastic performance at all three stages than both the moderately impaired and severely impaired groups (who did not significantly differ from each other). Conclusions The findings add to growing evidence that cognitive clusters in FEP mirror that of later-stage schizophrenia. They also suggest that premorbid scholastic performance may not just be a risk factor for developing schizophrenia, but is also related to cognitive impairment severity and potentially to prognosis.

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Impaired meaning-based cognitive skills are specifically associated with poorer subjective quality of life in schizophrenia

Cited by 5 publications

References 43 publications

Longitudinal clinical and functional outcome in distinct cognitive subgroups of first-episode psychosis: a cluster analysis

Longitudinal clinical and functional outcome in distinct cognitive subgroups of first-episode psychosis: a cluster analysis

Factors Impacting Access and Engagement of Cognitive Remediation Therapy for People with Schizophrenia: A Systematic Review

Cognitive heterogeneity in first-episode psychosis and its relationship with premorbid developmental adjustment

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