Cited by 214Schizophrenia research and treatmentPsychological Testing and AssessmentMental Health and Psychiatry

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Exploring cognitive complaints in schizophrenia: the subjective scale to investigate cognition in schizophrenia

Stip, E, Caron, J, Renaud, S, Pampoulova, T, Lecomte, Y·2003·Comprehensive Psychiatry

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Abstract

While it has become commonplace to test the various components of memory in schizophrenia with paper-and-pencil or in-lab tasks, very little data exist on the subjective complaints of patients regarding their memory. Few instruments have been designed to collect systematically the complaints of patients with schizophrenia. We present a work in progress on the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS), a 21-item, Likert-type scale that is simple and easy to use. It allows a quantitative approach to the subjective and cognitive dimensions of schizophrenia. Stip constructed the scale based on a questionnaire covering several cognitive domains: memory (working memory, explicit long-term memory), attention (divided, distractibility, alertness, sustained), language, and praxia. We evaluated the psychometric properties of the SSTICS in a population of 114 French-speaking patients in Montreal. Patients were recruited in the community and assessed with the Structured Clinical Interview for DSM-III-R (SCID), the Positive and Negative Syndrome Scale (PANSS), and the Extrapyramidal Symptoms Rating Scale (ESRS). Cognition was measured using the Rey Auditory Verbal Learning Test (RAVLT) (long-term memory), Controlled Oral Word Association Test (verbal fluency), and Trails A and B. Preliminary analyses showed very good internal consistency for the global score (alpha=0.88), and alphas varying from 0.57 to 0.72 for the subscales. Stability over time was very good. T…

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Assessing Community Functioning and Independent Living Skills of Individuals with Severe Mental Illness
Sánchez, J., Chan, F., Yaghmaian, R. A., Johnson, E. T., Pfaller, J. S., & Umucu, E. (2016) · Journal of Applied Rehabilitation Counseling · doi:10.1891/0047-2220.47.3.6 · Cited by 3
Cognitive Remediation and Psychosocial Rehabilitation for Individuals with Severe Mental Illness
McGurk, S. R., Eack, S. M., Kurtz, M. M., & Mueser, K. T. (2012) · Rehabilitation Research and Practice · doi:10.1155/2012/283602 · Cited by 3
Douleur et schizophrénie : quand l’esprit ignore les appels grandissants de la moelle
Potvin, S. (2013) · Springer eBooks · doi:10.1007/978-2-8178-0307-4_9 · Cited by 3
Reply to Stip and colleagues
Ueland, T., Grimstad, K., Sørensen, H., Øie, M., & Vaskinn, A. (2026) · Schizophrenia Research: Cognition · doi:10.1016/j.scog.2026.100429 · Cited by 2
“…is crucial for understanding the underlying construct of the SACCS and differentiating it from other validated scales such as the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) (Stip et al., 2003) and the Screen for Cognitive Impairment in Psychiatry (SCIP) (Purdon, 2005).”
Influential
Why clinical neuropsychology matters in schizophrenia care
Øie, M. G., Barbosa, F., Lettner, S., Baker, G. A., Duarte, C., Hessen, E., & Ueland, T. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1713751 · Cited by 3
“…(never) to 4 (very often) on a Likert scale, each assessing perceived difficulties in attention, memory, executive functions, language, and praxia; total scores are calculated by summing ratings across items, with higher scores indicating greater subjective cognitive impairment (Stip et al., 2003).”
iCogCA to Promote Cognitive Health Through Digital Group Interventions for Individuals Living With a Schizophrenia Spectrum Disorder: Protocol for a Nonrandomized Concurrent Controlled Trial
Au‐Yeung, C., Thai, H., Best, M. W., Bowie, C. R., Guimond, S., Lavigne, K. M., Menon, M., Moritz, S., Piat, M., Sauvé, G., et al. (2025) · JMIR Research Protocols · doi:10.2196/63269 · Cited by 1
Psychometric properties of the Spanish version of the measure of insight into cognition‐self‐report in psychosis‐risk and non‐clinical Mexican young adults
Fresán, A., Domínguez, T., Flores, Y., Nieto, L., Sheinbaum, T., Robles, R., & Medalia, A. (2024) · Early Intervention in Psychiatry · doi:10.1111/eip.13559 · Cited by 2
“The concept of ‘ neurocognitive insight ’ describes the awareness of subjective neuro-cognitive complaints (e.g., impaired attention, memory and problem-solving; Medalia & Thysen, 2008; Stip et al., 2003).”
Validation of the Persian Version of Measure of Insight into Cognition Self-report (MIC-SR) in Patients with Schizophrenia
Mazhari, S., Jahanbakhsh, F., Soliemanizadeh, S., & Raaii, F. (2023) · Zahedan Journal of Research in Medical Sciences · doi:10.5812/zjrms-126567 · Cited by 2
“Lately, researchers have suggested that schizophrenia patients are not only unaware of their psychotic symptoms, but they are also unaware of their cognitive problems, such as attention, memory, and problem solving (8-13).”
Background
Executive functioning of older adults with bipolar disorder
Omer, E., Braw, Y., Amiaz, R., & Ravona‐Springer, R. (2020) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5402 · Cited by 4
“(b) Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS): A 21-item self-rated questionnaire evaluating subjective cognitive complaints in the domains of attention, memory, executive functioning, language and praxia.(28) Participants rated the frequency of their complaints on a scale of 0 (never) to 4 (…”
Method
A BIAS AGAINST DISCONFIRMATORY EVIDENCE IS ASSOCIATED WITH DELUSIONS IN SCHIZOPHRENIA
Woodward, T. S., Moritz, S., Ngan, E. T. C., & Speechley, W. (2008) · doi:10.1016/s0920-9964(08)70400-6 · Cited by 2
Could Schizophrenia Be a Refractory Condition to Central Pain Sensitization
Grignon, S., Stavro, K., & Potvin, S. (2014) · Springer eBooks · doi:10.1007/978-2-8178-0414-9_9 · Cited by 2
Treating Unmet Needs in Psychiatry (TUNE-UP): targeted service increases out-patient initiations of clozapine
Khan, Z. A., Varvari, I., Mancini, V., Zita-Zauchenberger, C., Kantor, S., Fanshawe, J., Musiiwa, S., Pledge, A., Pearce, B., de Vauvert, S. J. G. N. D. L. M. D. B., et al. (2026) · BJPsych Open · doi:10.1192/bjo.2026.10988 · Cited by 1
The ANCog: A French self-report scale for assessing subjective cognitive complaints in rehabilitation samples
Graux, J., Thillay, A., Sommer, J., Morel‐Kohlmeyer, S., Peyroux, É., Visser, M., Jehenne-Cousty, A., Leloup, J., Molina, J., Brénugat-Herné, L., et al. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116830
Treating Unmet Needs in Psychiatry (TUNE-UP): A Targeted Service Increases Outpatient Initiations of ClozapinePreprint
Khan, Z., Varvari, I., Mancini, V., Zauchenberger, C., Kantor, S., Fanshawe, J., Musiiwa, S., Pledge, A., Pearce, B., Motte, S. D. D. L., et al. (2025) · medRxiv · doi:10.1101/2025.04.04.25325236 · Cited by 1
‘Minds@Work’ Intervention for Job Tenure of Workers Living with Severe Mental Illness: A Feasibility and Acceptability Pilot Case Series
Sauvé, G., Corbière, M., Raucher-Chéné, D., Hotte-Meunier, A., & Lepage, M. (2024) · Journal of Psychosocial Rehabilitation and Mental Health · doi:10.1007/s40737-024-00439-7 · Cited by 1
“) (Stip et al., 2003).”
Validation of the Cognitive Assessment Instrument for Obsessions and Compulsions (CAIOC-13) in an Indian Sample
Bhattacharya, M., Kashyap, H., Balachander, S., & Reddy, Y. C. J. (2024) · Indian Journal of Psychological Medicine · doi:10.1177/02537176241245330 · Cited by 1
“Existing scales to assess subjective reports of cognitive difficulties 12,13 are not specific to the difficulties evinced by individuals with OCD.”
Examining the effects of subjective and objective neurocognition on recovery within serious mental illness: the role of diagnostic disclosure
Fowler, C. A., Faith, L. A., Murphy, M. E., & Rempfer, M. V. (2022) · Psychosis · doi:10.1080/17522439.2022.2089206 · Cited by 1
“Subjective complaints were measured using the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS; Stip et al., 2003) in which participants rate their perceptions of cognitive difficulties using a 5-point Likert-type scale.”
Method
Psychometric Validation of a Novel PRO MEASURE for Assessing Patient-reported Experience of Cognitive Impairment in Schizophrenia (PRECIS)Preprint
Rosen, R., Trudeau, J., Silverstein, S., Henderson, D. C., Smith, A., Walling, D., García, M., Davis, B. A., Derogatis, L., & Sand, M. (2019) · Research Square · doi:10.21203/rs.2.13957/v1 · Cited by 1
“These include the Schizophrenia Cognition Rating Scale (SCoRS) [9], which assesses the effect of cognitive deficits on day-to-day functioning, the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) test battery [10], the Cambridge Neuropsychological Test Automated Battery (CANTAB) [11],…”
MethodInfluential
L’évaluation des fonctions neurocognitives dans la schizophrénie : de l’examen complémentaire à la fonction thérapeutique
Langlois, T., Olivier, F., & Amoyal, C. (2012) · doi:10.1016/j.jtcc.2012.07.001 · Cited by 1
Eficacia de un programa de entrenamiento en atención en la esquizofrenia : un estudio piloto
Gil, D., Palacios, M., Sánchez, R., Gómez, I., Gutiérrez, E., Ramiro, G., & Fuentecilla, A. (2012) · doi:10.5944/rppc.vol.17.num.1.2012.10368 · Cited by 1
L’indifférence à la douleur dans la schizophrénie
Potvin, S. (2011) · Douleur et Analgésie · doi:10.1007/s11724-011-0261-9 · Cited by 1
Is there really a dissociation between consciousness of cognitive deficits and insight into the symptoms of the disease in schizophrenia?
Raffard, S., Capdevielle, D., Boulenger, J., & Bayard, S. (2009) · Schizophrenia Research · doi:10.1016/j.schres.2009.01.003 · Cited by 1
A Vulnerability-Stress-Coping Model Of Adjustment To The Individual Negative Symptoms Of Schizophrenia
Watson-Luke, A. (2007) · doi:10.14264/158520 · Cited by 1
“Stip et al. (2003) found a positive association between total scores on a measure subjective appraisals of cognitive problems, including poor attention and alogia symptoms, and the general psychopathology and negative symptom subscales of the PANSS (Kay et al., 1987).”
Background
Does Telephone Based Intervention Combined with Face to Face Contact Improve Socio-Occupational Functioning of Persons with Schizophrenia? A Retrospective Chart Review
Juliet, S. H. O., Joseph, J., Sims, S., Annamalai, K., Venkatraman, L., Raghavan, V., & Padmavati, R. (2021) · Journal of Psychosocial Rehabilitation and Mental Health · doi:10.1007/s40737-021-00240-w
Compensatory Cognitive Training—Cultural Adaptation to Persons with Schizophrenia in India
Gopal, S., Balasubramanian, S., Venkatraman, L., Akshaya, A., Pavithra, R., Padmavati, R., & Dark, F. L. (2021) · Journal of Psychosocial Rehabilitation and Mental Health · doi:10.1007/s40737-021-00231-x · Cited by 5
Cognitive complaints in body dysmorphic disorder: An exploratory characterization across clinical and community samples
Court, K. H. À., Rheenen, T. E. V., & Rossell, S. L. (2026) · Psychological Medicine · doi:10.1017/s0033291726105030
“…populations – the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA; Rosa et al., 2013) and the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS; Stip et al., 2003) – and supplemented with novel items targeting BDD-relevant experiences (see Supplementary Table S1).”
DREAMSPHEN: a randomised controlled study comparing dose reduction of antipsychotics vs maintenance treatment in schizophrenia spectrum disorder after stratification based on patients’ psychotic phenotype – study protocol of a personalised medicine approach
Berna, F., Horowitz, M., Javelot, H., Meyer, N., & Foucher, J. R. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-117593
“42 The recovery process will be assessed by means of the Questionnaire about the Process of Recovery (QPR 43 ).”
Validation of the German version of the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS)
Hahne, I., Böge, K., Zierhut, M., Bergmann, N., Schulze, T., Hahn, E., Bajbouj, M., Calvano, C., Moritz, S., Gajic, V., et al. (2026) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2026.2627998
“However, research shows low correlations between subjective and objective measures of cognition in people with SSD, though these measures are typically more strongly correlated in healthy control groups (Moritz et al., 2004; Sellwood et al., 2013; Stip et al., 2003; Stratta et al., 2020).”
Influential
Subjective cognitive functioning in psychosis deserves more attention: Practical tips and recommendations
Bryce, S., Stainton, A., McDermott, J., Rigter, M., & Allott, K. (2025) · Australasian Psychiatry · doi:10.1177/10398562251371623
“4,5 People with psychotic disorders report greater levels of subjective cognitive problems than non-clinical groups on these types of scales.”
Impaired effort allocation in schizophrenia
Blouzard, E., Cignetti, F., Meyniel, F., Pouchon, A., Polosan, M., Bastin, J., & Dondé, C. (2025) · Schizophrenia Research: Cognition · doi:10.1016/j.scog.2025.100378
“…(Jackson-Koku, 2016), the Calgary Depression Scale for Schizophrenia (CDSS) (Addington et al., 1993), Subjective Quality of Life (SQoL) (Boyer et al., 2010), Beck Cognitive Insight (BCI) (Beck et al., 2004) and Subjective Scale to Investigate Cognition in schizophrenia (SSTICS) (Stip et al., 2003).”
Flowers for Algernon: How metacognition affects quality of life in schizophrenia. Structural equation modeling with the FACE-SZ cohort
Frileux, S., Faivre, N., Urbach, M., Vidal, N., Bottemanne, H., Berna, F. S., Belmonte, C., Boyer, L., Capdevielle, D., Clauss, J. M. E., et al. (2025) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2025.152622 · Cited by 1
Métacognition : définition, évaluation et altération dans le trouble du spectre de la schizophrénie
Quiles, C. (2023) · EMC - Psychiatrie · doi:10.1016/s0246-1072(22)44410-5
Efficacy and auditory biomarker analysis of fronto-temporal transcranial direct current stimulation (tDCS) in targeting cognitive impairment associated with recent-onset schizophrenia: study protocol for a multicenter randomized double-blind sham-controlled trial
Dondé, C., Bastin, J., Pouchon, A., Costes, N., Fakra, E., Galvao, F., Gay, A., Haesebaert, F., Lamalle, L., Mérida, I., et al. (2023) · Trials · doi:10.1186/s13063-023-07160-z
“• Subjective experiences of cognitive impairment will be assessed using the self-rated Subjective Scale To Investigate Cognition in Schizophrenia (SSTICS) total score [39].”
BackgroundMethod
Improving autobiographical memory in schizophrenia using wearable cameras: A single-case experimental study
Dassing, R., Offerlin-Meyer, I., Cugnot, A., Danion, J., Krasny‐Pacini, A., & Berna, F. S. (2022) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2022.2155668
“The general cognitive complaint was assessed with the Subjective Scale To Investigate Cognition in Schizophrenia (SSTICS; Stip et al., 2003).”
Method
Subjective Cognitive Complaints in Unaffected First-Degree Relatives of Schizophrenia Patients: Relation to Cognitive Performance, Psychotic Experiences, and Social Functioning
Baliga, S. P., Kedare, J. S., Mankar, U. J., & Kamath, R. M. (2021) · Indian Journal of Psychological Medicine · doi:10.1177/02537176211010504 · Cited by 1
Remédiation cognitive dans la schizophrénie
Manoli, R., & Franck, N. (2021) · EMC - Psychiatrie · doi:10.1016/s0246-1072(21)44173-8
Réhabilitation psychosociale
Franck, N. (2020) · EMC - Psychiatrie · doi:10.1016/s0246-1072(20)44160-4
Remédiation cognitive dans la schizophrénie
Franck, N. (2014) · EMC - Psychiatrie · doi:10.1016/s0246-1072(13)64355-2
Cognitive Remediation
McLeod, H. J., & King, R. (2012) · Wiley eBooks · doi:10.1002/9781118702703.ch9 · Cited by 3
25. Remédiation cognitive
Franck, N. (2012) · doi:10.1016/b978-2-294-73908-8.00008-2
Pertinence des outils cognitifs pour le diagnostic précoce de schizophrénie
Vidailhet, P., & Dalery, J. (2006) · L Encéphale · doi:10.1016/s0013-7006(06)76256-x
“Il serait également intéressant d’utiliser des échelles subjectives [par exemple échelle SSTICS (38) ou échelle SCoRS (24)] qui permettent d’explorer les troubles que le sujet met lui-même en avant dans ses difficultés quotidiennes : peut-être ces troubles pourront-ils ainsi être appréhendés de façon plus précoce que…”
Background
A Cognitive Rehabilitation Program for Psychoses: Origins, Development and Perspectives
Kontis, D., Theochari, E., Andreopoulou, A., Vassilouli, S., Giannakopoulou, D., Siettou, E., Kouloumbi, M., Tsichlakis, A., & Tsaltas, E. (2018) · doi:10.26386/obrela.v1i1.6
Chapitre 3 – Déficits neurocognitifs et remédiation cognitive
Vianin, P. (2012) · Elsevier eBooks · doi:10.1016/b978-2-294-71342-2.00003-6

Authors: Stip, E., Caron, J., Renaud, S., Pampoulova, T., & Lecomte, Y.
Affiliations: Université de Montréal (CA)
Institut universitaire en santé mentale de Montréal (CA)
Douglas Mental Health University Institute (CA)
ORCID: Caron, J
Venue: Comprehensive Psychiatry
Publisher: Elsevier BV
Published: 2003-07
Volume: 44
Issue: 4
Pages: 331-340
ISSN: 0010-440X (ISSN-L)
DOI: 10.1016/s0010-440x(03)00086-5
OpenAlex: W2076371841
Cited by: 214
References: 0
Citations by year: 2026: 8 · 2025: 15 · 2024: 10 · 2023: 9 · 2022: 5 · 2021: 12 · 2020: 14 · 2019: 9 · 2018: 9 · 2017: 11 · 2016: 8 · 2015: 10 · 2014: 11 · 2013: 10 · 2012: 17
FWCI: 2.45
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Comprehensive Psychiatry (publishedVersion)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords: schizophrenia, subjective cognitive complaints, memory impairment, working memory, long-term memory, attention, psychometric validation, internal consistency, test-retest stability, subjective-objective correlation, French-speaking patients
MeSH terms: Adult, Cognition Disorders, Female, Humans, Male, Neuropsychological Tests, Pilot Projects, Surveys and Questionnaires, Schizophrenia, Severity of Illness Index, Reproducibility of Results, Diagnostic and Statistical Manual of Mental Disorders

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Exploring cognitive complaints in schizophrenia: the subjective scale to investigate cognition in schizophrenia

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