Insight in cognitive impairment assessed with the Cognitive Assessment Interview in a large sample of patients with schizophrenia

• Published in: European archives of psychiatry and clinical neuroscience Vol. 274; no. 6; pp. 1343 - 1354
• Main Authors: Bucci, Paola, Mucci, Armida, Giordano, Giulia M., Caporusso, Edoardo, Giuliani, Luigi, Gibertoni, Dino, Rossi, Alessandro, Rocca, Paola, Bertolino, Alessandro, Galderisi, Silvana
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2024; Springer Nature B.V
• Subjects: Adult; Aged; Agreements; Cognition; Cognitive ability; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - etiology; Cognitive Dysfunction - physiopathology; Female; Humans; Interview, Psychological; Male; Medicine; Medicine & Public Health; Mental disorders; Middle Aged; Neuropsychological Tests; Neurosciences; Original Paper; Patients; Psychiatric Status Rating Scales; Psychiatry; Schizophrenia; Schizophrenia - complications; Schizophrenia - physiopathology; Schizophrenic Psychology; Young Adult; Schizophrenia; Insight; Co-primary measure; Cognitive impairment; Functioning
• ISSN: 0940-1334; 1433-8491; 1433-8491
• DOI: 10.1007/s00406-023-01641-7

The Cognitive Assessment Interview (CAI) is an interview-based scale measuring cognitive impairment and its impact on functioning in subjects with schizophrenia (SCZ). The present study aimed at assessing, in a large sample of SCZ ( n  = 601), the agreement between patients and their informants on CAI ratings, to explore patients’ insight in their cognitive deficits and its relationships with clinical and functional indices. Agreement between patient- and informant-based ratings was assessed by the Gwet’s agreement coefficient. Predictors of insight in cognitive deficits were explored by stepwise multiple regression analyses. Patients reported lower severity of cognitive impairment vs. informants. A substantial to almost perfect agreement was observed between patients’ and informants’ ratings. Lower insight in cognitive deficits was associated to greater severity of neurocognitive impairment and positive symptoms, lower severity of depressive symptoms, and older age. Worse real-life functioning was associated to lower insight in cognitive deficit, worse neurocognitive performance, and worse functional capacity. Our findings indicate that the CAI is a valid co-primary measure with the interview to patients providing a reliable assessment of their cognitive deficits. In the absence of informants with good knowledge of the subject, the interview to the patient may represent a valid alternative.