Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.
Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Soc Psychiatry Psychiatr Epidemiol. 2022 Mar;57(3):435-460. doi: 10.1007/s00127-021-02120-x. Epub 2021 Jun 18.
Cognitive difficulties are common in people with severe mental disorders (SMDs) and various measures of cognition are of proven validity. However, there is a lack of systematic evidence regarding the psychometric properties of these measures in low- and middle-income countries (LMICs).
To systematically review the psychometric properties of cognitive measures validated in people with SMDs in LMICs.
We conducted a systematic review of the literature by searching from four electronic databases. Two authors independently screened studies for their eligibility. Measurement properties of measures in all included studies were extracted. All eligible measures were assessed against criteria set for clinical and research recommendations. Results are summarized narratively and measures were grouped by measurement type and population.
We identified 23 unique measures from 28 studies. None of these was from low-income settings. Seventeen of the measures were performance-based. The majority (n = 16/23) of the measures were validated in people with schizophrenia. The most commonly reported measurement properties were: known group, convergent, and divergent validity (n = 25/28). For most psychometric property, studies of methodological qualities were found to be doubtful. Among measures evaluated in people with schizophrenia, Brief Assessment of Cognition in Schizophrenia, Cognitive Assessment Interview, MATRICS Consensus Cognitive Battery, and CogState Schizophrenia Battery were with the highest scores for clinical and research recommendation.
Studies included in our review provide only limited quality evidence and future studies should consider adapting and validating measures using stronger designs and methods. Nonetheless, validated assessments of cognition could help in the management and allocating therapy in people with SMDs in LMICs.
认知障碍在严重精神障碍（SMD）患者中很常见，各种认知测量方法的有效性已得到证实。然而，在中低收入国家（LMIC），关于这些方法的心理测量特性的系统证据仍然缺乏。
系统综述在中低收入国家（LMIC）中验证的用于评估 SMD 患者认知功能的认知测量工具的心理测量特性。
我们从四个电子数据库中进行了系统文献检索。两名作者独立筛选研究的入选资格。从所有纳入研究中提取测量工具的测量特性。所有合格的工具都按照临床和研究推荐的标准进行评估。结果以叙述性方式进行总结，并根据测量类型和人群对工具进行分组。
我们从 28 项研究中确定了 23 个独特的测量工具。这些工具没有一个来自低收入国家。其中 17 个是基于表现的。大多数（n = 16/23）的工具都是在精神分裂症患者中进行验证的。报告最多的测量特性是：已知组、收敛和发散效度（n = 25/28）。对于大多数心理测量特性，研究的方法学质量被认为是可疑的。在评估精神分裂症患者的工具中，简短认知评估量表、认知评估访谈、MATRICS 共识认知电池和 CogState 精神分裂症电池在临床和研究推荐方面得分最高。
我们综述中纳入的研究仅提供了有限的质量证据，未来的研究应考虑使用更强的设计和方法来适应和验证这些工具。尽管如此，经验证的认知评估工具可以帮助中低收入国家 SMD 患者的管理和治疗分配。
