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Memory and attention performance in psychiatric patients: Lack of correspondence between clinician-rated and patient-rated functioning with neuropsychological test results

Published online by Cambridge University Press:  01 July 2004

STEFFEN MORITZ ,
SABINE FERAHLI  and
DIETER NABER
STEFFEN MORITZ
Affiliation:
University Hospital Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany
SABINE FERAHLI
Affiliation:
University Hospital Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany
DIETER NABER
Affiliation:
University Hospital Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany
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Abstract

In the present study, the correspondence between clinician-assessed and self-reported neurocognitive performance was contrasted with scores obtained from psychometric neuropsychological tests in 148 psychiatric in-patients. Results revealed that self-reported cognitive functioning was strongly associated with depressive symptomatology but was only poorly related to psychometric neurocognitive performance, particularly in schizophrenia. After illness denial was controlled for, the overall association between subjective and objective test performance was slightly increased but still failed to reach significance in six out of eight analyses. In approximately 20% to 40% of all cases, clinicians judged memory performance to be normal despite substantial impairment revealed by neuropsychological test results (attention parameters: 7–51%). Since (ecological) validity and reliability have been demonstrated for many neurocognitive paradigms, the present results question the validity of non-psychometric neurocognitive assessment and call for a complementation of clinical judgment with neurocognitive assessment. Reasons for decreased sensitivity of self-reported and clinician-assessed neurocognitive functioning are discussed. (JINS, 2004, 10, 623–633.)

Keywords

NeuropsychologyPsychometric testsSelf-reportClinical judgmentMemoryAttention
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 10 , Issue 4 , July 2004 , pp. 623 - 633
Copyright
2004 The International Neuropsychological Society

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References

REFERENCES

Antikainen, R., Hanninen, T., Honkalampi, K., Hintikka, J., Koivumaa-Honkanen, H., Tanskanen, A., & Viinamaki, H. (2001). Mood improvement reduces memory complaints in depressed patients. European Archives of Psychiatry and Clinical Neuroscience, 251, 6–11.CrossRefGoogle Scholar
Austin, M.P., Mitchell, P., & Goodwin, G.M. (2001). Cognitive deficits in depression: Possible implications for functional neuropathology. British Journal of Psychiatry, 178, 200–206.CrossRefGoogle Scholar
Bates, M.E., Bowden, S.C., & Barry, D. (2002). Neurocognitive impairment associated with alcohol use disorders: Implications for treatment. Experimental and Clinical Psychopharmacology, 10, 193–212.CrossRefGoogle Scholar
Brekke, J.S., Raine, A., Ansel, M., Lencz, T., & Bird, L. (1997). Neuropsychological and psychophysiological correlates of psychosocial functioning in schizophrenia. Schizophrenia Bulletin, 23, 19–28.CrossRefGoogle Scholar
Brickenkamp, R. (1978). Test d2. Handanweisung [Test d2. Manual]. Göttingen, Germany: Hogrefe.
Chen, E.Y., Kwok, C.L., Chen, R.Y., & Kwong, P.P. (2001). Insight changes in acute psychotic episodes: a prospective study of Hong Kong Chinese patients. Journal of Nervous and Mental Disease, 189, 24–30.CrossRefGoogle Scholar
Cuesta, M.J., Peralta, V., & Juan, J.A. (1996). Abnormal subjective experiences in schizophrenia: Its relationships with neuropsychological disturbances and frontal signs. European Archives of Psychiatry and Clinical Neuroscience, 246, 101–105.CrossRefGoogle Scholar
Donohoe, G., Owens, N., O'Donnell, C., Burke, T., Moore, L., Tobin, A., & O'Callaghan, E. (2001). Predictors of compliance with neuroleptic medication among inpatients with schizophrenia: a discriminant function analysis. European Psychiatry, 16, 293–298.CrossRefGoogle Scholar
Giovagnoli, A.R., Mascheroni, S., & Avanzini, G. (1997). Self-reporting of everyday memory in patients with epilepsy: relation to neuropsychological, clinical, pathological and treatment factors. Epilepsy Research, 28, 119–128.CrossRefGoogle Scholar
Gold, J.M., Goldberg, R.W., McNary, S.W., Dixon, L.B., & Lehman, A.F. (2002). Cognitive correlates of job tenure among patients with severe mental illness. American Journal of Psychiatry, 159, 1395–1402.CrossRefGoogle Scholar
Green, M.F. (1996). What are the functional consequences of neurocognitive deficits in schizophrenia? American Journal of Psychiatry, 153, 321–330.Google Scholar
Green, M.F., Kern, R.S., Braff, D.L., & Mintz, J. (2000). Neurocognitive deficits and functional outcome in schizophrenia: Are we measuring the “right stuff”? Schizophrenia Bulletin, 26, 119–136.Google Scholar
Harvey, P.D., Serper, M.R., White, L., Parrella, M.J., McGurk, S.R., Moriarty, P.J., Bowie, C., Vadhan, N., Friedman, J., & Davis, K.L. (2001). The convergence of neuropsychological testing and clinical ratings of cognitive impairment in patients with schizophrenia. Comprehensive Psychiatry, 42, 306–313.CrossRefGoogle Scholar
Helmstaedter, C., Hauff, M., & Elger, C.E. (1998). Ecological validity of list-learning tests and self-reported memory in healthy individuals and those with temporal lobe epilepsy. Journal of Clinical and Experimental Neuropsychology, 20, 365–375.CrossRefGoogle Scholar
Helmstaedter, C., Lendt, M., & Lux, S. (2001). Verbaler Lern- und Merkfähigkeitstest [Verbal Learning and Memory Test]. Göttingen, Germany: Beltz.
Heubrock, D. (1992). Der Auditiv-Verbale Lerntest (AVLT) in der klinischen und experimentellen Neuropsychologie. Durchführung, Auswertung und Forschungsergebnisse [The Auditory-Verbal Learning Test (AVLT) in clinical and experimental neuropsychology. Administration, evaluation, and research findings]. Zeitschrift für Differentielle und Diagnostische Psychologie, 3, 161–174.Google Scholar
Horner, M.D., Harvey, R.T., & Denier, C.A. (1999). Self-report and objective measures of cognitive deficit in patients entering substance abuse treatment. Psychiatry Research, 86, 155–161.CrossRefGoogle Scholar
Kopelman, M.D., Stanhope, N., & Guinan, E. (1998). Subjective memory evaluations in patients with focal frontal diencephalic and temporal lobe lesion. Cortex, 34, 191–207.CrossRefGoogle Scholar
Krausz, M., Moritz, S., Lambert, M., & Naber, D. (2000). Dosage of conventional neuroleptic medication and subjective cognitive functioning in schizophrenia. International Clinical Psychopharmacology, 15, 77–81.CrossRefGoogle Scholar
Kurtz, M.M., Moberg, P.J., Gur, R.C., & Gur, R.E. (2001). Approaches to cognitive remediation of neuropsychological deficits in schizophrenia: A review and meta-analysis. Neuropsychology Review, 11, 197–210.CrossRefGoogle Scholar
Lannoo, E., Colardyn, F., Vandekerckhove, T., Deyne, C. de, Soete, G. de, & Jannes, C. (1998). Subjective complaints versus neuropsychological test performance after moderate to severe head injury. Acta Neurochirugica, 140, 245–253.CrossRefGoogle Scholar
Le Fevre, P.D. (2001). Improving the physical health of patients with schizophrenia: Therapeutic nihilism or realism? Scottish Medical Journal, 46, 11–13.Google Scholar
Lezak, M.D. (1995). Neuropsychological assessment. (3rd ed.). Oxford, UK: Oxford University Press.
Meehl, P.E. (1997). Credentialed persons, credentialed knowledge. Clinical Psychology: Science and Practice, 4, 91–98.CrossRefGoogle Scholar
Moore, L.H., van Gorp, W.G., Hinkin, C.H., Stern, M.J., Swales, T., & Satz, P. (1997). Subjective complaints versus actual cognitive deficits in predominantly symptomatic HIV-1 seropositive individuals. Journal of Neuropsychiatry and Clinical Neurosciences, 9, 37–44.Google Scholar
Moritz, S., Iverson, G., & Woodward, T.S. (2003). Reliable change indexes for memory performance in schizophrenia as a means to determine drug-induced cognitive decline. Applied Neuropsychology, 10, 115–120.CrossRefGoogle Scholar
Moritz, S., Kloss, M., Jahn, H., Hand, I., Haasen, C., & Krausz, M. (2002a). Executive functioning in obsessive-compulsive disorder, unipolar depression and schizophrenia. Archives of Clinical Neuropsychology, 17, 477–483.Google Scholar
Moritz, S., Krausz, M., Gottwalz, E., Lambert, M., Perro, C., Ganzer, S., & Naber, D. (2000). Cognitive dysfunction at baseline predicts symptomatic one-year outcome in first-episode schizophrenics. Psychopathology, 33, 48–51.CrossRefGoogle Scholar
Moritz, S., Perro, C., Woodward, T.S., & Krausz, M. (2002b). Subjective cognitive dysfunction in first-episode patients predicts symptomatic outcome: A replication. Psychopathology, 35, 367–368.Google Scholar
Moritz, S., Woodward, T.S., PERSIST Study Group, Krausz, M., & Naber, D. (2002c). Relationship between neuroleptic dosage and subjective cognitive dysfunction in schizophrenic patients treated with either conventional or atypical neuroleptic medication. International Clinical Psychopharmacology, 17, 41–44.Google Scholar
Newman, S., Klinger, L., Venn, G., Smith, P., Harrison, M., & Treasure, T. (1989). Subjective reports of cognition in relation to assessed cognitive performance following coronary artery bypass surgery. Journal of Psychosomatic Research, 33, 227–233.CrossRefGoogle Scholar
Nishiyama, K., Sugishita, M., Kurisaki, H., & Sakuta, M. (1998). Reversible memory disturbance and intelligence impairment induced by long-term anticholinergic therapy. Internal Medicine, 37, 514–518.CrossRefGoogle Scholar
Nixon, S.J. & Phillips, J.A. (1999). Neurocognitive deficits and recovery in chronic alcohol abuse. CNS Spectrums, 4, 95–102.CrossRefGoogle Scholar
Perez, M. & Godoy, J. (1998). Comparison between a “traditional” memory test and a “behavioral” memory battery in Spanish patients. Journal of Clinical and Experimental Neuropsychology, 20, 496–502.CrossRefGoogle Scholar
Rammsayer, T.H., Rodewald, S., & Groh, D. (2000). Dopamine-antagonistic, anticholinergic, and GABAergic effects on declarative and procedural memory functions. Brain Research, 9, 61–71.Google Scholar
Reitan, R.M. (1992). Trail Making Test. Manual of administration and scoring. Tuscon, AZ: Reitan Neuropsychology Laboratory.
Rossell, S.L., Coakes, J., Shapleske, J., Woodruff, P.W.R., & David, A.S. (2003). Insight: Its relationship with cognitive function, brain volume and symptoms in schizophrenia. Psychological Medicine, 33, 111–119.CrossRefGoogle Scholar
Smith, G.E., Petersen, R.C., Ivnik, R.J., Malec, J.F., & Tangalos, E.G. (1996). Subjective memory complaints, psychological distress, and longitudinal change in objective memory performance. Psychology and Aging, 11, 272–279.CrossRefGoogle Scholar
Strome, T.M. (1989). Schizophrenia in the elderly: What nurses need to know. Archives of Psychiatric Nursing, 3, 47–52.Google Scholar
Theml, T. & Romero, B. (1991). Selbstbeurteilung von Aufmerksamkeitsdefiziten bei Alzheimer-Kranken mit sehr leichter Demenz. Eine explorative Studie [Self-reported attention deficits in patients with mild dementia of the Alzheimer type. A preliminary study]. Zeitschrift für Neuropsychologie, 12, 151–159.Google Scholar
Tonne, U., Hiltunen, A.J., Vikander, B., Engelbrektsson, K., Bergman, H., Bergman, I., Leifman, H., & Borg, S. (1995). Neuropsychological changes during steady-state drug use, withdrawal and abstinence in primary benzodiazepine-dependent patients. Acta Psychiatrica Scandinavica, 91, 299–304.CrossRefGoogle Scholar
Vadhan, N.P., Serper, M.R., Harvey, P.D., Chou, J.C.-Y., & Cancro, R. (2001). Convergent validity and neuropsychological correlates of the schedule for the assessment of negative symptoms (SANS) attention subscale. Journal of Nervous and Mental Disease, 189, 637–641.CrossRefGoogle Scholar
van den Bosch, R.J. & Rombouts, R.P. (1998). Causal mechanisms of subjective cognitive dysfunction in schizophrenic and depressed patients. Journal of Nervous and Mental Disease, 186, 364–368.CrossRefGoogle Scholar
Velligan, D.I., Bow-Thomas, C.C., Mahurin, R.K., Miller, A.L., & Halgunseth, L.C. (2000). Do specific neurocognitive deficits predict specific domains of community function in schizophrenia? Journal of Nervous and Mental Disease, 188, 518–524.Google Scholar
von Zerssen, D. & Koeller, D.M. (1976). Paranoid-Depressivitäts Skala (PDS) [Paranoid-Depression Scale]. Göttingen, Germany: Hogrefe.
Wagle, A.C., Berrios, G.E., & Ho, L. (1999). The cognitive failures questionnaire in psychiatry. Comprehensive Psychiatry, 40, 478–484.CrossRefGoogle Scholar
Wilder-Willis, K.E., Shear, P.K., Steffen, J.J., & Borkin, J. (2002). The relationship between cognitive dysfunction and coping abilities in schizophrenia. Schizophrenia Research, 55, 259–267.CrossRefGoogle Scholar
Wilson, B., Cockburn, J., & Baddeley, A. (1992). Rivermead Behavioural Memory Test. German translation. Bury St. Edmunds, UK: Thames Valley Test Company.
World Health Organization. (1993). The ICD-10 classification of mental and behavioural disorders: Primary health care classification. Geneva: WHO.
Zimmerman, M. & Mattia, J.I. (1999). Psychiatric diagnosis in clinical practice: is comorbidity being missed? Comprehensive Psychiatry, 40, 182–191.Google Scholar
Zimmermann, P. & Fimm, B. (1994). Testbatterie zur Aufmerksamkeitsprüfung (TAP) [Test Battery for the Assessment of Attentional Dysfunction]. Herzogenrath, Germany: Psytest.
Zimmermann, P., Messner, C., Poser, U., & Sedelmeier, P. (1991). Ein Fragebogen erlebter Defizite der Aufmerksamkeit (FEDA) [a questionnaire measuring self-experienced deficits of attention]. Freiburg, Germany: Psychologisches Institut der Universität Freiburg.