Research Division, Institute of Mental Health, Singapore, Singapore.
Research Division, Institute of Mental Health, Singapore, Singapore.
Schizophr Res. 2018 Sep;199:58-63. doi: 10.1016/j.schres.2018.03.008. Epub 2018 Mar 14.
Cognitive impairment is one of the core features of schizophrenia. For its evaluation, current clinical practice relies on detailed neuropsychological batteries which require trained testers and considerable amount of time to administer. Therefore, a brief and reliable screening tool for identification of overall cognitive impairment prior to a detailed comprehensive neurocognitive assessment is needed in a busy clinical setting. This study evaluates the clinical utility of the Montreal Cognitive Assessment (MoCA) in detecting cognitive impairments in schizophrenia and its relationship with functional outcome and demographic characters.
The MoCA, the Brief Assessment of Cognition in Schizophrenia (BACS), and the Brief UCSD Performance-based Skills Assessment (UPSA-B) were administered to 64 patients with schizophrenia. Mild and severe cognitive impairments were defined as BACS Z-score (calculated with the age and gender adjustments using previously published local norm data) of one or two standard deviations below the mean, respectively.
The results showed that the MoCA was significantly correlated with BACS (r=.61, p<.001) and sensitive to detect both mild (AUC=0.82, p<.001) and severe (AUC=0.81, p<.001) cognitive impairments in schizophrenia. The MoCA was significantly correlated with UPSA-B score (r=.51, p<.001), and accounted for significant additional variance in UPSA-B score beyond the BACS.
These findings indicate that MoCA is a useful bedside cognitive screening instrument for people with schizophrenia.
认知障碍是精神分裂症的核心特征之一。目前的临床实践评估认知功能依赖于详细的神经心理学测试，这些测试需要经过培训的测试人员，并需要大量的时间来进行。因此，在繁忙的临床环境中，需要一种简短而可靠的筛查工具，以便在进行详细的全面认知评估之前，确定总体认知障碍。本研究评估了蒙特利尔认知评估（MoCA）在检测精神分裂症认知障碍方面的临床效用，及其与功能结局和人口统计学特征的关系。
对 64 名精神分裂症患者进行了 MoCA、简短认知评估精神分裂症量表（BACS）和简短 UCSD 基于表现的技能评估（UPSA-B）的评估。轻度和重度认知障碍定义为 BACS Z 分数（使用先前发表的本地正常数据进行年龄和性别调整后计算）低于平均值一个或两个标准差。
结果表明，MoCA 与 BACS 显著相关（r=.61，p<.001），能够敏感地检测精神分裂症中的轻度（AUC=0.82，p<.001）和重度（AUC=0.81，p<.001）认知障碍。MoCA 与 UPSA-B 评分显著相关（r=.51，p<.001），并且在 UPSA-B 评分中，除了 BACS 之外，还解释了显著的额外方差。
这些发现表明，MoCA 是一种有用的精神分裂症患者床边认知筛查工具。
