Lima Flávia M, Cardoso Taiane A, Serafim Sílvia D, Martins Dayane S, Solé Brisa, Martínez-Arán Anabel, Vieta Eduard, Rosa Adriane R
Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Trends Psychiatry Psychother. 2018;40(2):170-178. doi: 10.1590/2237-6089-2017-0121.
In Brazil, there is no valid instrument to measure subjective cognitive dysfunction in bipolar disorder. The present study analyzed the psychometric properties of the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) in Brazilian bipolar patients. We further investigated the relationship between the COBRA, objective cognitive measures, and illness course variables.
The total sample (N=150) included 85 bipolar disorder patients and 65 healthy controls. The psychometric properties of the COBRA (e.g., internal consistency, concurrent validity, discriminative validity, factor analyses, ROC curve, and feasibility) were analyzed.
The COBRA showed a one-factor structure with very high internal consistency (Cronbach's alpha=0.890). Concurrent validity was indicated by a strong correlation with the cognitive domain of the FAST (r=0.811, p<0.001). Bipolar patients experienced greater cognitive complaints (mean=14.69; standard deviation [SD]=10.03) than healthy controls (mean=6.78; SD=5.49; p<0.001), suggesting discriminative validity of the instrument. No significant correlations were found between the COBRA and objective cognitive measures. Furthermore, higher COBRA scores were associated with residual depressive (r=0.448; p<0.001) and manic (r=0.376; p<0.001) symptoms, number of depressive episodes (r=0.306; p=0.011), number of total episodes (r=0.256; p=0.038), and suicide attempts (r=0.356; p=0.003).
The COBRA is a valid instrument to assess cognitive complaints, and the combined use of subjective-objective cognitive measures enables the correct identification of cognitive dysfunctions in bipolar disorder.
在巴西，尚无有效的工具来测量双相情感障碍中的主观认知功能障碍。本研究分析了巴西双相情感障碍患者中双相情感障碍认知主诉评定量表（COBRA）的心理测量特性。我们进一步研究了COBRA、客观认知测量与病程变量之间的关系。
总样本（N = 150）包括85名双相情感障碍患者和65名健康对照者。分析了COBRA的心理测量特性（例如，内部一致性、同时效度、区分效度、因子分析、ROC曲线和可行性）。
COBRA显示出单因素结构，内部一致性非常高（克朗巴哈系数=0.890）。与FAST认知领域的强相关性表明了同时效度（r = 0.811，p<0.001）。双相情感障碍患者比健康对照者经历了更多的认知主诉（均值=14.69；标准差[SD]=10.03）（均值=6.78；SD = 5.49；p<0.001），表明该工具具有区分效度。未发现COBRA与客观认知测量之间存在显著相关性。此外，较高的COBRA评分与残留抑郁症状（r = 0.448；p<0.001）、躁狂症状（r = 0.376；p<0.001）、抑郁发作次数（r = 0.306；p = 0.011）、总发作次数（r = 0.256；p = 0.038）和自杀企图（r = 0.356；p = 0.003）相关。
COBRA是评估认知主诉的有效工具，主观-客观认知测量的联合使用能够正确识别双相情感障碍中的认知功能障碍。
