Keefe Richard S E, Poe Margaret, Walker Trina M, Kang Joseph W, Harvey Philip D
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Am J Psychiatry. 2006 Mar;163(3):426-32. doi: 10.1176/appi.ajp.163.3.426.
Interview-based measures of cognition may serve as potential coprimary measures in clinical trials of cognitive-enhancing drugs for schizophrenia. However, there is no such valid scale available. Interviews of patients and their clinicians are not valid in that they are unrelated to patients' levels of cognitive impairment as assessed by cognitive performance tests. This study describes the reliability and validity of a new interview-based assessment of cognition, the Schizophrenia Cognition Rating Scale (SCoRS), that involves interviews with patients and informants.
Sixty patients with schizophrenia were assessed with the SCoRS and three potential validators of an interview-based measure of cognition: cognitive performance, as measured by the Brief Assessment of Cognition in Schizophrenia (BACS); real-world functioning, as measured by the Independent Living Skills Inventory; and functional capacity, as measured by the University of California, San Diego, Performance-Based Skills Assessment (UPSA).
The SCoRS global ratings were significantly correlated with composite scores of cognitive performance and functional capacity and with ratings of real-world functioning. Multiple regression analyses suggested that SCoRS global ratings predicted unique variance in real-world functioning beyond that predicted by the performance measures.
An interview-based measure of cognition that included informant reports was related to cognitive performance as well as real-world functioning. Interview-based measures of cognition, such as the SCoRS, may be valid coprimary measures for clinical trials assessing cognitive change and may also aid clinicians desiring to assess patients' level of cognitive impairment.
在精神分裂症认知增强药物的临床试验中,基于访谈的认知测量方法可能作为潜在的共同主要测量指标。然而,目前尚无这样有效的量表。对患者及其临床医生的访谈并不有效,因为它们与通过认知表现测试评估的患者认知损害水平无关。本研究描述了一种新的基于访谈的认知评估方法——精神分裂症认知评定量表(SCoRS)的信度和效度,该量表涉及对患者和提供信息者的访谈。
对60例精神分裂症患者进行SCoRS评估,并使用三种基于访谈的认知测量方法的潜在验证指标:通过精神分裂症认知简短评估(BACS)测量的认知表现;通过独立生活技能量表测量的现实世界功能;以及通过加利福尼亚大学圣地亚哥分校基于表现的技能评估(UPSA)测量的功能能力。
SCoRS总体评分与认知表现和功能能力的综合评分以及现实世界功能评分显著相关。多元回归分析表明,SCoRS总体评分预测了现实世界功能中超出表现测量所预测的独特变异。
一种包括信息提供者报告的基于访谈的认知测量方法与认知表现以及现实世界功能相关。基于访谈的认知测量方法,如SCoRS,可能是评估认知变化的临床试验的有效共同主要测量指标,也可能有助于希望评估患者认知损害水平的临床医生。