Paul Roux1,2,3, Mathieu Urbach1,2,3, Sandrine Fonteneau1,2,3, Fabrice Berna1,4, Lore Brunel1,5, Delphine Capdevielle1,6, Isabelle Chereau1,7, Julien Dubreucq1,8, Catherine Faget-Agius1,9, Guillaume Fond1, Sylvain Leignier1,8, Claire-Cécile Perier1,8, Raphaëlle Richieri1,9, Priscille Schneider1,4, Franck Schürhoff1,5, Anne Marie Tronche1,7, Hanan Yazbek1,6, Anna Zinetti-Bertschy1,4, Christine Passerieux1,2,3, Eric Brunet-Gouet1,2,3. 1. 1 Fondation FondaMental, Créteil, France. 2. 2 Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France. 3. 3 HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France. 4. 4 Strasbourg University Hospital, INSERM U1114, Strasbourg Federation of Translational Psychiatry, University of Strasbourg, Strasbourg, France. 5. 5 INSERM U955, Translational Psychiatry Team, Université Paris-Est Créteil (UPEC), AP-HP, DHU Pe-PSY, Department of Adult Psychiatry, Henri Mondor University Hospitals, Créteil, France. 6. 6 University Department of Adult Psychiatry, La Colombière Hospital, CHU Montpellier, University of Montpellier 1, INSERM 1061, Montpellier, France. 7. 7 CMP B, Clermont-Ferrand University Hospital, EA 7280, Faculty of Medicine, Auvergne University, Clermont-Ferrand Cedex 1, France. 8. 8 Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France. 9. 9 Academic Department of Psychiatry (AP-HM), Sainte-Marguerite University Hospital, Marseille, France.
Abstract
OBJECTIVE: : This study aimed to evaluate the validity of the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale (ECPDS) to discriminate for cognitive impairment in schizophrenia. DESIGN: : This multicentre cross-sectional study used a validation design with receiver operating characteristic (ROC) curve analysis. SETTINGS:: The study was undertaken in a French network of seven outward referral centres. SUBJECTS: : We recruited individuals with clinically stable schizophrenia diagnosed based on the Structured Clinical Interview for assessing Diagnostic and Statistical Manual of Mental Disorders (4th ed., rev.; DSM-IV-R) criteria. MAIN MEASURES:: The index test for cognitive impairment was ECPDS (independent variable), a 13-item scale completed by a relative of the participant. The reference standard was a standardized test battery that evaluated seven cognitive domains. Cognitive impairment was the dependent variable and was defined as an average z-score more than 1 SD below the normative mean in two or more cognitive domains. RESULTS: : Overall, 97 patients were included (67 with schizophrenia, 28 with schizoaffective disorder, and 2 with schizophreniform disorder). The mean age was 30.2 (SD 7.7) years, and there were 75 men (77.3%). There were 59 (60.8%) patients with cognitive impairment on the neuropsychological battery, and the mean ECPDS score was 27.3 (SD 7.3). The ROC curve analysis showed that the optimal ECPDS cut-off was 29.5. The area under the curve was 0.77, with 76.3% specificity and 71.1% sensitivity to discriminate against cognitive impairment. CONCLUSION: : The ECPDS is a valid triage tool for detecting cognitive impairment in schizophrenia, before using an extensive neuropsychological battery, and holds promise for use in everyday clinical practice.
OBJECTIVE: : This study aimed to evaluate the validity of the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale (ECPDS) to discriminate for cognitive impairment in schizophrenia. DESIGN: : This multicentre cross-sectional study used a validation design with receiver operating characteristic (ROC) curve analysis. SETTINGS:: The study was undertaken in a French network of seven outward referral centres. SUBJECTS: : We recruited individuals with clinically stable schizophrenia diagnosed based on the Structured Clinical Interview for assessing Diagnostic and Statistical Manual of Mental Disorders (4th ed., rev.; DSM-IV-R) criteria. MAIN MEASURES:: The index test for cognitive impairment was ECPDS (independent variable), a 13-item scale completed by a relative of the participant. The reference standard was a standardized test battery that evaluated seven cognitive domains. Cognitive impairment was the dependent variable and was defined as an average z-score more than 1 SD below the normative mean in two or more cognitive domains. RESULTS: : Overall, 97 patients were included (67 with schizophrenia, 28 with schizoaffective disorder, and 2 with schizophreniform disorder). The mean age was 30.2 (SD 7.7) years, and there were 75 men (77.3%). There were 59 (60.8%) patients with cognitive impairment on the neuropsychological battery, and the mean ECPDS score was 27.3 (SD 7.3). The ROC curve analysis showed that the optimal ECPDS cut-off was 29.5. The area under the curve was 0.77, with 76.3% specificity and 71.1% sensitivity to discriminate against cognitive impairment. CONCLUSION: : The ECPDS is a valid triage tool for detecting cognitive impairment in schizophrenia, before using an extensive neuropsychological battery, and holds promise for use in everyday clinical practice.