Norms and standardization of the Brief Assessment of Cognition in Schizophrenia (BACS)

Keefe, Richard S.E.; Harvey, Philip D.; Goldberg, Terry E.; Gold, James M.; Walker, Trina M.; Kennel, Courtney; Hawkins, Kirsten A.

doi:10.1016/j.schres.2008.03.024

Cited by 291 publications

(227 citation statements)

References 4 publications

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“…Potential limitations are the open-label design and possible practice effects, although we used alternate forms of the BACS. 13 Tocilizumab was not associated with improvements in psychopathology; however, subjects were clinically stable with mild baseline illness severity. In rheumatoid arthritis, tocilizumab dosing is increased to 8 mg/kg after the first infusion.…”

Section: J Clin Psychiatry 77:2 February 2016mentioning

confidence: 94%

An Open-Label, Pilot Trial of Adjunctive Tocilizumab in Schizophrenia

Miller¹,

Dias²,

Lemos³

et al. 2016

J. Clin. Psychiatry

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To the Editor: Interest and enthusiasm for research on the immunology of schizophrenia has, arguably, taken a prominent role in the field. Adjunctive antiinflammatory treatment may be associated with improvement in psychopathology and cognition in some patients with schizophrenia. 1,2 Interleukin-6 (IL-6) is an inflammatory cytokine produced by blood leukocytes and central nervous system microglia and astrocytes. IL-6 levels are elevated and associated with psychopathology, smaller hippocampal volume, and poorer cognition in schizophrenia. [3][4][5] We hypothesized that adjunctive tocilizumab-a humanized IL-6 receptor monoclonal antibody-would improve cognition in schizophrenia, an important determinant of quality of life and functioning. Method. With Institutional Review Board approval and anInvestigational New Drug waiver from the US Food and Drug Administration (FDA), we conducted an 8-week open-label trial of adjunctive tocilizumab in schizophrenia (ClinicalTrials.gov Identifier NCT01696929). All subjects provided written informed consent, and a Data Safety Monitoring Board, which included a psychiatrist and rheumatologist, provided study oversight.Tocilizumab is FDA approved for adults with rheumatoid arthritis and juvenile idiopathic arthritis and is administered as an intravenous infusion every 4 weeks. Subjects were aged 18-55 years, had a DSM-IV diagnosis of schizophrenia or schizoaffective disorder, were taking a non-clozapine antipsychotic, had no psychiatric hospitalizations in the past 3 months, and were on stable psychotropic medications for ≥ 1 month.Exclusion criteria were taking scheduled immunomodulatory agents; having a history of immune disorder; using an illicit drug in the past month; having unstable medical conditions; having active or chronic infections; and being pregnant, breastfeeding, or being a reproductive-age female not using contraception.After screening, subjects received 4 mg/kg of tocilizumab at baseline and 4 weeks. Psychopathology (Positive and Negative Syndrome Scale 6 [PANSS], cognition (Brief Assessment of Cognition in Schizophrenia 7 [BACS], alternate forms of testing) and fasting serum high-sensitivity C-reactive protein (hsCRP) and cytokine levels were assessed at baseline and weeks 2, 4, and 8. Changes in psychopathology and cognition were analyzed using a paired t test, 2-sided, using a last-observation carried forward approach; P values were considered statistically significant at the α = .05 level. It is illegal to post this copyrighted PDF on any website. J Clin Psychiatry 77:2, February 2016Letters to the Editor Results. Eight subjects were enrolled; 2 were excluded after screening. Although 6 subjects entered the trial, 1 was removed after the first infusion because psychosocial stressors required psychiatric hospitalization. All week-4 study assessments were completed by the subject; however, a second infusion was not administered. Thus, 5 subjects completed the trial. Demographic and clinical characteristics are presented in Table 1. Infusions were well tolera...

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Section: J Clin Psychiatry 77:2 February 2016mentioning

confidence: 94%

An Open-Label, Pilot Trial of Adjunctive Tocilizumab in Schizophrenia

Miller¹,

Dias²,

Lemos³

et al. 2016

J. Clin. Psychiatry

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“…All participants completed the DPX task 22 and the Brief Assessment of Cognition in Schizophrenia test battery (BACS), 24 a measure of global neuropsychological functioning. Diagnostic interviews for all subjects were completed using the Structured Clinical Interview for DSM-IV (SCID-IV).…”

Section: Participantsmentioning

confidence: 99%

Impaired Context Processing is Attributable to Global Neuropsychological Impairment in Schizophrenia and Psychotic Bipolar Disorder

Reilly

Hill

Gold

et al. 2016

SCHBUL

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Background: Context processing may reflect a specific cognitive impairment in schizophrenia. Whether impaired context processing is observed across psychotic disorders or among relatives of affected individuals, and whether it is a deficit that is independent from the generalized neuropsychological deficits seen in psychotic disorders, are less established. Methods: Schizophrenia, schizoaffective, and psychotic bipolar probands (n = 660), their first-degree relatives (n = 741), and healthy individuals (n = 308) studied by the Bipolar-Schizophrenia Network on Intermediate Phenotypes consortium performed an expectancy task requiring use of contextual information to overcome a prepotent response. Sensitivity for target detection and false alarm rates on trials requiring inhibition or goal maintenance were measured. Results: Proband groups and relatives with psychosis spectrum personality traits demonstrated reduced target sensitivity and elevated false alarm rates. False alarm rate was higher under inhibition vs goal maintenance conditions although this difference was attenuated in schizophrenia and schizoaffective proband groups. After accounting for global neuropsychological impairment, as reflected by the composite score from the Brief Assessment of Cognition in Schizophrenia neuropsychological battery, deficits in schizophrenia and bipolar proband groups were no longer significant. Performance measures were moderately familial. Conclusion: Reduced target detection, but not a specific deficit in context processing, is observed across psychotic disorders. Impairments in both goal maintenance and response inhibition appear to contribute comparably to deficits in schizophrenia and schizoaffective disorder, whereas greater difficulty with response inhibition underlies deficits in bipolar disorder. Yet, these deficits are not independent from the generalized neurocognitive impairment observed in schizophrenia and psychotic bipolar disorder.

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“…The growing research on other methods for assessing cognitive function (e.g., self-report, clinician interview) suggests that they have limited correlation with objective measures of cognitive performance (137), though they may still have utility in predicting functional status (137)(138)(139)(140)(141)(142)(143)(144). If a formal assessment of cognition is not possible, it is still important for the clinician to use the best available information to make a judgment about the individual's cognitive function, including the clinician's interactions with the patient and/or reports of family members or clinical staff.…”

Section: Measuring Cognition In the Dsm-5mentioning

confidence: 99%

Cognitive impairments in psychotic disorders: common mechanisms and measurement

2014

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Decades of research have provided robust evidence of cognitive impairments in psychotic disorders. Individuals with schizophrenia appear to be impaired on the majority of neuropsychological tasks, leading some researchers to argue for a "generalized deficit", in which the multitude of cognitive impairments are the result of a common neurobiological source. One such common mechanism may be an inability to actively represent goal information in working memory as a means to guide behavior, with the associated neurobiological impairment being a disturbance in the function of the dorsolateral prefrontal cortex. Here, we provide a discussion of the evidence for such impairment in schizophrenia, and how it manifests in domains typically referred to as cognitive control, working memory and episodic memory. We also briefly discuss cognitive impairment in affective psychoses, reporting that the degree of impairment is worse in schizophrenia than in bipolar disorder and psychotic major depression, but the profile of impairment is similar, possibly reflecting common mechanisms at the neural level. Given the recent release of the DSM-5, we end with a brief discussion on assessing cognition in the context of diagnosis and treatment planning in psychotic disorders.

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Norms and standardization of the Brief Assessment of Cognition in Schizophrenia (BACS)

Cited by 291 publications

References 4 publications

An Open-Label, Pilot Trial of Adjunctive Tocilizumab in Schizophrenia

An Open-Label, Pilot Trial of Adjunctive Tocilizumab in Schizophrenia

Impaired Context Processing is Attributable to Global Neuropsychological Impairment in Schizophrenia and Psychotic Bipolar Disorder

Cognitive impairments in psychotic disorders: common mechanisms and measurement

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