University Department of Psychiatry, Campus Antwerp University Hospital (UZA) , Antwerp , Belgium.
Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UA) , Antwerp , Belgium.
Int J Psychiatry Clin Pract. 2019 Sep;23(3):171-177. doi: 10.1080/13651501.2019.1571210. Epub 2019 May 13.
The diagnoses of solvent-induced chronic toxic encephalopathy (CSE) can be supported by neuropsychological tests. However, since results not only reflect cognitive functioning but also the patient's effort to perform well, this study examines to what extent underperformance impacts neuropsychological outcomes in individuals referred for suspected CSE. : A retrospective study of 48 suspected CSE patients having completed ten neuropsychological tests assessing different domains of cognition. Underperformance was identified using the Amsterdam Short-Term Memory Test and the Rey 15-item Memory Test (FIT). Multiple linear regression was applied to examine the effect of insufficient effort on test performance. A total of 54.1% of the patients were identified as having underperformed on one or both performance validity tests. Analyses showed a significant effect of underperformance on most tests barring letter-number sequencing. Most of the neuropsychological tests evaluated showed significant effects of underperformance. Performance on letter-number sequencing was not affected. In case of underperformance, the results of the neuropsychological assessment should be disregarded when weighing the final multi-disciplinary diagnosis, with the exception of letter-number sequencing. Key points A total of 54.1% of patients with suspected CSE referred for neuropsychological assessment was identified as having underperformed on one or both PVTs. Underperformance has a significant effect on most neuropsychological tests with the exception of letter-number sequencing assessing attention and working memory. In case of underperformance, the results of the neuropsychological assessment should be disregarded when weighing the final multi-disciplinary diagnosis, with the exception of letter-number sequencing.
溶剂诱导的慢性中毒性脑症（CSE）的诊断可以通过神经心理学测试来支持。然而，由于测试结果不仅反映了认知功能，还反映了患者的表现努力程度，因此本研究旨在探讨在怀疑患有 CSE 的患者中，表现不佳对神经心理学结果的影响程度。
本研究为回顾性研究，共纳入了 48 名疑似 CSE 患者，这些患者完成了十项评估不同认知领域的神经心理学测试。使用阿姆斯特丹短期记忆测试（AST）和 Rey 15 项记忆测试（FIT）来识别表现不佳。采用多元线性回归分析来检验努力不足对测试表现的影响。结果显示，共有 54.1%的患者在一项或两项表现有效性测试中表现不佳。分析显示，在大多数测试中，表现不佳对测试结果有显著影响，但字母数字排序测试除外。评估的大多数神经心理学测试都显示出表现不佳的显著影响。字母数字排序测试的表现不受影响。在表现不佳的情况下，应在权衡最终的多学科诊断时，忽略神经心理学评估的结果，字母数字排序测试除外。
共有 54.1%的疑似 CSE 患者在神经心理学评估中被确定为在一项或两项 PVT 中表现不佳。
表现不佳对大多数神经心理学测试有显著影响，但字母数字排序测试除外，该测试评估注意力和工作记忆。
在表现不佳的情况下，应在权衡最终的多学科诊断时，忽略神经心理学评估的结果，字母数字排序测试除外。
