Subjective cognitive complaints and relations to objective cognitive performance among Lebanese patients with schizophrenia

Abstract

Background Patients with schizophrenia have a particularly low level of insight into their illness compared to people with other mental health disorders. The objectives of the study were to evaluate: 1) subjective cognitive complaints in individuals with schizophrenia in comparison with health controls, 2) the relation between subjective cognitive complaint (SCC) and objective cognitive performance in the patients group, and 3) factors related to cognitive complaint, such as depression, insight, autonomy, and psychological symptoms. Methods Cross-sectional study was conducted between July 2019 and March 2020 enrolled 120 patients with schizophrenia disorders, selected from the Psychiatric Hospital of the Cross (HPC) – Lebanon and 60 healthy controls. The Self-Assessment Scale of Cognitive Complaints in Schizophrenia (SASCCS) was used to measure people living with schizophrenia perception of their cognitive impairment, while the Brief Assessment of Cognition in Schizophrenia (BACS) was used to evaluate their cognitive functioning. Results A significant difference was found between schizophrenia patients and healthy controls in all neurocognition and SASCCS tests. The hierarchical regression analysis showed that the BACS total score (Beta = −.06, p = .04), the PANSS general psychopathology (Beta = .29, p = .003), higher depression (Beta = .75, p = .003) were significantly associated with higher SCC. However, higher autonomy (Beta = − 6.35, p = .001) was significantly associated with lower SCC. A Structural equation model showed that the two most contributing variables were general psychopathology (Standardized Beta (SB): .33, p < 0.001) and autonomy (SB: −.29, p < 0.001). Conclusion A significant proportion of patients with schizophrenia could estimate their cognitive impairment. It also showed a positive correlation between depression and activity of daily living with SCC, suggesting that this aspect should be investigated alongside the clinical symptoms when a patient with schizophrenia presents with SCC.

Cross-cultural differences through subjective cognition: illustration in translatology with the SSTIC-E in the UAE

“…For example, Stratta et al (2020) found a mean score of 23.34 (SD = ±14.91) when validating the SSTICS in an Italian patient population ( Stratta et al, 2020 ), while Lecardeur et al (2009) reported a mean score of 24.73 (SD = ±9.56) for patients with schizophrenia who had preserved awareness of their cognitive deficits, as measured by the SSTICS ( Lecardeur et al, 2009 ). In contrast, Haddad et al (2021) found that subjective cognitive complaints were associated with poorer cognitive performance in Lebanese patients with schizophrenia, with patients scoring 25.15 (SD = 16.67; min = 0, max = 76; median = 23.50) and controls scoring 9.15 (SD = 7.63; min = 0, max = 37; median = 7.00) ( Haddad et al, 2021 ). The lowest mean score for SSTICS among patients was reported by Baliga et al (2020) in India, with a mean score of 16.22 (SD = ± 10.8) (Baliga et al, 2022).…”

“…This scale was originally constructed and validated in parallel in the two official Canadian languages, French and English. Since its inception, there have been more than 20 publications in PubMed that employed this scale, and it has been used in clinical studies translated into five languages, namely Italian ( Stratta et al, 2020 ), Castilian ( Bengochea Seco et al, 2010 ), Mandarin/Taiwan ( Chuang et al, 2019 ), Korean ( Shin et al, 2016 ), Hindi ( Baliga et al, 2020 ), and Tunisian Arabic or SASCCS ( Johnson et al, 2009 ; Bouhamed et al, 2021 ; Haddad et al, 2021 ).…”

Subjective cognitive complaints in first episode psychosis: A focused follow-up on sex effect and alcohol usage

“…When we correlated the Calgary Depressions Scale for Schizophrenia (CDSS) at baseline with SSTICS scores at the baseline, our study found no correlation with all items of the CDSS except with “7- early awakening”, where there was a significant correlation ( r = −0.256, p adjusted = 0.02). In a study assessing the first perceptions of cognition impairments and cognition functions among 120 schizophrenic patients in a psychiatric hospital in Lebanon, and 60 healthy controls using both self-assessment scales for cognitive complaints (SASCCS), and brief assessment of cognition in schizophrenia (BACS), Haddad and colleagues ( Haddad et al, 2021 ) reported positive correlations between SASCCS and CDSS scores, suggesting that patients with more depression symptoms tend to complain more about their cognitive problems. The possible reasons for different results are the difference between patients' demographics and cultural aspects between Lebanon and Canada.…”

The self-assessment scale of cognitive complaints in Schizophrenia: validation of the Arabic version among a sample of lebanese patients

“…Exclusion criteria included any conditions that could impair cognitive function, such as brain injuries, neurological problems, or ongoing substance use. This study is part of a broader project and used the same methodology as a previous study [ 17 ].…”

“…Recent studies have revealed that a significant proportion of patients with schizophrenia had severe cognitive impairments but did not report subjective deficits or display a full awareness of their cognitive disturbances [ 27 , 28 ]. For this reason, most clinicians rely on neuropsychological assessments to determine the cognitive status of patients rather than self-report measures and often underestimate the degree of cognitive impairment in patients with schizophrenia and their ability to evaluate their cognitive deficits [ 17 ].…”