TY - JOUR
T1 - Abbreviated neuropsychological assessment in schizophrenia
T2 - Prediction of different aspects of outcome
AU - Harvey, Philip D.
AU - Keefe, Richard S.E.
AU - Patterson, Thomas L.
AU - Heaton, Robert K.
AU - Bowie, Christopher R.
N1 - Funding Information:
Richard S. E. Keefe: Past (1–2 years): Abbott (advisory board, as of 1/26/07); Astra-Zeneca (advisory board, as of 5/20/06; Speaker, as of 10/20/06); Gabriel Pharmaceuticals (consulting, as of 7/25/06); Otsuka (consulting, as of 5/ 15/07); Pfizer (research funding, as of 5/15/07); Saegis (advisory board, as of 5/25/06; consulting, as of 5/25/06). Current/active: Acadia (consulting); Astra Zeneca (unrestricted educational funding); Bristol Myers Squibb (consulting); Cephalon (consulting); Cortex (consulting); Cyberonics (consulting, as of 10/2006); Dainippon Sumitomo Pharma (consulting, as of 3/25/07); Eli Lilly Laboratories (advisory board; consulting; research funding; Speaker); Johnson & Johnson (consulting; research funding, pending); Lundbeck (consulting); Memory Pharmaceuticals (advisory board; consulting); Merck (consulting); Orexigen (consulting); Organon Pharmaceuticals (advisory board; unrestricted educational funding); Pfizer (consulting); Sanofi/Aventis (advisory board; consulting); Xenoport (consulting). Royalties received: Brief Assessment of Cognition (BACS); Measurement and Treatment Research for Improving Cognition in Schizophrenia (MATRICS) Battery (BACS Symbol Coding). Personal stake: Director of Neurocognitive Assessment Unit for CATIE Project; Member of MATRICS Neurocognition Committee; Director of Treatment Units for Reducing Neuropsychological Symptoms (TURNS) Chief Neuropsychologists Group. Christopher R. Bowie has current grant support from Johnson and Johnson, Inc. Thomas L. Patterson and Robert K. Heaton have no current conflicts.
Funding Information:
Philip D. Harvey has served as an advisor or consultant to: Astra-Zeneca Pharmaceuticals, Bristol-Myers Squibb, Eli Lilly and Company, Johnson and Johnson, Inc., Memory Pharmaceuticals, Novartis Pharmaceuticals, Pfizer, Inc., SolvayWyeth Alliance, and the Sanofi-Aventis Group. He has current or immediately prior grant or contract support from: Astra-Zeneca Pharmaceuticals, Bristol Myers Squibb, Johnson and Johnson, Inc., and Pfizer, Inc.
Funding Information:
This research was supported by National Institute of Mental Health (NIMH) Grant MH 63116 (Philip D. Harvey), and the Department of Veterans Affairs Veterans Integrated Service Network 3 Mental Illness Research, Education, and Clinical Center (VISN-3 MIRECC). For conflict of interest statements relating to all authors, please see the Appendix. Address correspondence to Philip D. Harvey, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Woodruff Memorial Building, 101 Woodruff Circle, Suite 4000, Atlanta, GA 30032, USA (E-mail: Philip.Harvey@Emory.edu).
PY - 2009/5
Y1 - 2009/5
N2 - The aim of this study was to identify the best subset of neuropsychological tests for prediction of several different aspects of functioning in a large (n = 236) sample of older people with schizophrenia. While the validity of abbreviated assessment methods has been examined before, there has never been a comparative study of the prediction of different elements of cognitive impairment, real-world outcomes, and performance-based measures of functional capacity. Scores on 10 different tests from a neuropsychological assessment battery were used to predict global neuropsychological (NP) performance (indexed with averaged scores or calculated general deficit scores), performance-based indices of everyday-living skills and social competence, and case-manager ratings of real-world functioning. Forward entry stepwise regression analyses were used to identify the best predictors for each of the outcomes measures. Then, the analyses were adjusted for estimated premorbid IQ, which reduced the magnitude, but not the structure, of the correlations. Substantial amounts (over 70%) of the variance in overall NP performance were accounted for by a limited number of NP tests. Considerable variance in measures of functional capacity was also accounted for by a limited number of tests. Different tests constituted the best predictor set for each outcome measure. A substantial proportion of the variance in several different NP and functional outcomes can be accounted for by a small number of NP tests that can be completed in a few minutes, although there is considerable unexplained variance. However, the abbreviated assessments that best predict different outcomes vary across outcomes. Future studies should determine whether responses to pharmacological and remediation treatments can be captured with brief assessments as well.
AB - The aim of this study was to identify the best subset of neuropsychological tests for prediction of several different aspects of functioning in a large (n = 236) sample of older people with schizophrenia. While the validity of abbreviated assessment methods has been examined before, there has never been a comparative study of the prediction of different elements of cognitive impairment, real-world outcomes, and performance-based measures of functional capacity. Scores on 10 different tests from a neuropsychological assessment battery were used to predict global neuropsychological (NP) performance (indexed with averaged scores or calculated general deficit scores), performance-based indices of everyday-living skills and social competence, and case-manager ratings of real-world functioning. Forward entry stepwise regression analyses were used to identify the best predictors for each of the outcomes measures. Then, the analyses were adjusted for estimated premorbid IQ, which reduced the magnitude, but not the structure, of the correlations. Substantial amounts (over 70%) of the variance in overall NP performance were accounted for by a limited number of NP tests. Considerable variance in measures of functional capacity was also accounted for by a limited number of tests. Different tests constituted the best predictor set for each outcome measure. A substantial proportion of the variance in several different NP and functional outcomes can be accounted for by a small number of NP tests that can be completed in a few minutes, although there is considerable unexplained variance. However, the abbreviated assessments that best predict different outcomes vary across outcomes. Future studies should determine whether responses to pharmacological and remediation treatments can be captured with brief assessments as well.
KW - Abbreviated assessments
KW - Disability
KW - Functional capacity
KW - Neuropsychological assessment
KW - Schizophrenia
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U2 - 10.1080/13803390802251386
DO - 10.1080/13803390802251386
M3 - Article
C2 - 18720182
AN - SCOPUS:67649910511
VL - 31
SP - 462
EP - 471
JO - Journal of Clinical and Experimental Neuropsychology
JF - Journal of Clinical and Experimental Neuropsychology
SN - 1380-3395
IS - 4
ER -