Osaka Kawasaki Rehabilitation University Repository
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Exploring the physiological impact of aromatic plants in horticultural activities: a study on autonomic nervous system responses
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Discrepancy between subjective and objective assessments of cognitive function in patients with schizophrenia
No full textBackground: Cognitive impairments in patients with schizophrenia can negatively impact upon their functional prognosis and create difficulties in daily life. However, the patients’ subjective perceptions of their cognitive impairments do not always align with their objectively measured performance. Understanding this discrepancy is thought to be important in the development of effective rehabilitation strategies. In this study, we aimed to clarify the characteristics of this discrepancy from a neurocognitive perspective.
Methods: We examined the discrepancy between subjective and objective ratings of cognition in 47 inpatients with schizophrenia. Cognitive complaints
were assessed using the Schizophrenia Cognition Rating Scale (SCoRS), which was completed by both patients and interviewers. Neurocognitive performance was measured with the Brief Assessment of Cognition in Schizophrenia (BACS). Discrepancy scores were calculated as the difference between self- and interviewer-ratings, and participants were classified into three groups: ‘overestimate’, ‘accurate’, and ‘underestimate’ (± 0.5 SD). We analyzed group differences in BACS composite and domain scores.
Results: Data were obtained from 47 inpatients with schizophrenia (20 men, 27 women; median age 47 [33-64] years). BACS scores did not significantly
differ among the three discrepancy groups, which indicates that patients’ subjective complaints of cognitive difficulties do not sufficiently reflect the level of objective cognitive impairment.
Conclusions: Patients’ self-reported difficulties related to cognitive function do not evidently correlate enough with the degree of neurocognitive impairment measured by the BACS. Our subjects were patients with severe cognitive impairment and psychotic symptoms. Factors other than cognitive function may influence the behaviors measured by SCoRS in patients with severe psychotic symptoms. Subjective difficulties reported by patients with schizophrenia hold clinical significance independent of objectively assessed cognitive impairment. This supports the importance of support based on the patient’s own omplaints as well as on test scores when developing rehabilitation strategies.Original Articlearticl