Subjective cognitive functioning, depressive symptoms, and objective cognitive functioning in people with treatment-resistant psychosis

ABSTRACT

Introduction: Relationships between subjective cognitive functioning (SCF), objective cognitive functioning (OCF), and depressive symptoms are poorly understood in treatment-resistant psychosis (TRP). This study (a) compares SCF in TRP using positively and negatively worded scales, (b) assess these scales’ accuracy, and (c) explores the association between these scales and depressive symptoms. We hypothesised that both SCF scales would be highly correlated, minimally associated with OCF, and similarly associated with depressive symptoms. Methods: Archival clinical data from 52 TRP inpatients was utilised. OCF composite scores were derived from a broad neuropsychological battery. SCF was assessed using the norm-referenced PROMIS 2.0 Cognitive Abilities (positively worded) and Concerns (negatively worded) subscales. A depressive symptom score was derived from the Positive and Negative Syndrome Scale. Results: SCF ratings were higher in patients than OCF. There was a small but significant correlation between PROMIS subscales (r = .30). Neither PROMIS subscale was associated with OCF (r = −.11, r = .01). Depressive symptoms were correlated with the positively (r = −.29) but not negatively worded scale (r = −.13). Conclusion: Individuals with TRP inaccurately rate their cognitive functioning and tend to overestimate their ability. Positively and negatively worded SCF scales associate variably with depressive symptoms, indicating they may not be used interchangeably in TRP.

KEYWORDS:

• Subjective cognitive functioning
• psychosis
• self-report measure
• depression
• wording

Acknowledgements

The authors would like to acknowledge the BC Psychosis Program which provided the clinical data for this study.

Disclosure statement

IJT has served as consultant for Community Living British Columbia. RP has received consulting fees or sat on paid advisory boards for Janssen, Lundbeck and Otsuka; is on the speaker's bureau for Janssen, Lundbeck and Otsuka. RW has received honoraria from HLS Therapeutics for advisory panel activities, and from Canadian Agency for Drugs and Technology in Health as a consultant. WGH has served as a consultant for AbbVie.

Data availability statement

Due to the nature of this research, no supporting clinical data is available.

Additional information

Funding

DZ was supported by the University of British Columbia Faculty of Medicine Summer Student Research Award. WGH was supported by the Jack Bell Chair in Schizophrenia. IJT was supported by the Michael Smith Health Research / BC Schizophrenia Society Foundation Health Professional Investigator Award.

Notes on contributors

Daniah Zumrawi

Daniah Zumrawi is a Research Assistant in the Department of Psychiatry at the University of British Columbia.

Brianne L. Glazier

Dr Brianne L. Glazier is a psychologist who works for Island Health in Mental Health and Substance Use Services.

Olga Leonova

Olga Leonova MD, PhD is a Research Associate at the Department of Psychiatry of the University of British Columbia.

Mahesh Menon

Mahesh Menon is a Clinical Professor in the Department of Psychiatry and clinical psychologist in the BC Psychosis Program at UBC Hospital.

Ric Procyshyn

Ric Procyshyn is a Clinical Professor of Psychiatry at University of British Columbia and Investigator within British Columbia Mental Health and Substance Use Services.

Randall White

Randall F. White is a Clinical Professor of Psychiatry at University of British Columbia and Clinical Director of the BC Psychosis Program at UBC Hospital.

Robert Stowe

Robert Stowe is a Clinical Professor of Psychiatry and Neurology at University of British Columbia, and a behavioral neurologist within the BC Neuropsychiatry Program.

William G. Honer

William G. Honer is Professor and Jack Bell Chair in Schizophrenia at the University of British Columbia, and Investigator within the British Columbia Mental Health and Substance Use Services Research Institute.

Ivan J. Torres

Ivan J. Torres is a Clinical Professor of Psychiatry at University of British Columbia and Investigator within British Columbia Mental Health and Substance Use Services.