La conscience des déficits neurocognitifs dans la schizophrénie : une méta-analyse

Abstract

Contexte La schizophrénie est un trouble allant de pair avec un manque d’autocritique par rapport aux délires et aux hallucinations. En contrepartie, on en sait beaucoup moins en ce qui concerne la conscience des patients par rapport à leurs déficits cognitifs, qui sont des symptômes clés de ce trouble psychiatrique. Afin de faire la synthèse de l’état de la connaissance à ce sujet, nous avons effectué une méta-analyse de 22 études comprenant 1609 patients. Les analyses ont révélé que les patients rapportent davantage de plaintes subjectives que les sujets sains. La corrélation entre la cognition subjective et objective s’est avérée faible toutefois. Les études utilisant la Scale to Investigate Cognition in Schizophrenia ont produit des corrélations plus fortes que celles utilisant d’autres échelles de plaintes subjectives. La relation entre la cognition subjective et les symptômes dépressifs s’est avérée comparable à la relation entre la cognition subjective et la cognition objective. Enfin, une relation faible a été observée entre la cognition subjective et l’autocritique par rapport aux symptômes positifs. Les résultats de la présente méta-analyse montrent que les patients atteints de la schizophrénie se plaignent de déficits cognitifs, mais qu’ils n’ont pas une représentation claire de la nature de ceux-ci, ce qui confirme l’existence de déficits méta-cognitifs dans la schizophrénie.

Self-Awareness Deficits of Cognitive Impairment in Individuals With Schizophrenia. Really?

“…Indeed, no differences between groups were found for working memory, attention, and executive functions subscores of the SSTICS. Concerning increased subjective cognitive complaint in patients in comparison with controls, this result is in accordance with the findings of the meta-analysis of Potvin et al (18) who have observed a similar results for the SSTICS total score.…”

“…Several measures have been previously used to measure self-report of cognitive functioning in individuals with schizophrenia. Among them the Cognitive Failures Questionnaire [CFQ; (14)], the Measure of insight into cognition-self-rated [MIC-SR; (15)], or the subjective scale to investigate cognition in schizophrenia [SSTICS, (16)] which is the most commonly used tool to assess self-awareness of cognitive functioning in this mental disorder (17,18).…”

“…To date, only one meta-analysis has been published on this subject (18). Several findings emerged from this meta-analysis and can be summarized as follows: 1) individuals with schizophrenia reported higher cognitive complaints than nonclinical controls; 2) modest associations between measures of objective and subjective cognition were found (the higher for problem-solving domain) 3) these relationships were higher when the study used the SSTICS to measure self-reported cognitive functioning in comparison with other scales, and 4) a weak association was found between depressive symptoms and cognitive complaint.…”

A Transnosographic Self-Assessment of Social Cognitive Impairments (ACSO): First Data

“…These studies reported indeed that the lack of insight on psychiatric symptoms (49) could be extended to cognitive impairments. More precisely, in accordance with Potvin et al (50), SZ patients have cognitive complaints but do not have a clear representation of the nature of their difficulties. While these studies focused on neurocognitive functioning, awareness into social cognition is only addressed in three studies (24, 51, 52).…”

Self-assessment of social cognition in a sample of Lebanese in-patients with schizophrenia

“…Moritz et al reported that schizophrenia participants were overconfident, even when making perceptual judgment mistakes, compared to a control group ( Moritz et al, 2014 ). A meta-analysis of 22 studies found that, when compared to controls, patients experienced more subjective cognitive complaints ( Potvin et al, 2014 ). Similarly, studies among patients with schizophrenia could demonstrate significant deficits across all social cognition domains compared to healthy controls ( Charernboon and Patumanond, 2017 , Peyroux et al, 2019 ).…”