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

机译:EPICOG-SCH:在稳定的门诊患者中筛选精神分裂症认知影响的简要电池

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摘要

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.
机译:需要简短的精神分裂症电池来筛选精神分裂症的认知影响。我们旨在验证和共同规范精神分裂症认知障碍的流行病学研究(EPICOG-SCH)得出的简短认知能力。对从234个中心招募的62例患者进行了门诊横断面评估。简短的电池包括全球知名的子测试,涵盖与功能结果相关的认知领域:WAIS-III-字母-数字-测序-LNS,类别流畅性测试-CFT,逻辑记忆立即调用-LM和Digit-Symbol-编码DSC。 CGI-SCH严重程度和WHO-DAS-S分别用于评估临床严重程度和功能障碍。获得了单位综合评分(UCS)和功能回归加权综合评分(FWCS);使用接收者操作特征(ROC)技术分析了FWCS的识别属性,以识别具有不同水平的功能障碍的患者。电池显示出良好的内部一致性,克朗巴赫(Cronbach)α= 0.78。跨CGI-SCH严重程度子量表的认知表现之间的差异为0.5到1 SD。电池的判别能力用于识别中度至残障程度最高的患者,其判别准确度相当高,曲线下面积(AUC)> 0.70,p <0.0001。 FWCS平均截止得分≥100时显示似然比(LR)最高为4.7,LR +为2.3,LR-为0.5。 FWCS临界值≥96在敏感性(0.74)和特异性(0.62)之间提供了最佳平衡.EPICOG-SCH被证明是筛查精神分裂症认知影响的有用简要工具,其回归加权综合得分为临床访谈的有效补充,可确认患者的潜在功能结局,并可用于在常规门诊随访期间监测认知。

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