Subjective Cognitive Complaints in Schizophrenia: Relation to Antipsychotic Medication Dose, Actual Cognitive Performance, Insight and Symptoms
Open accessAbstract
BACKGROUND: Subjective cognitive complaints are prevalent in those affected by functional psychoses and a variety of possible associated factors have been investigated. However, few studies have examined these potential factors within single studies or analyses. METHODS: Patients with a history of a schizophrenia spectrum disorder (n = 115) and a non-clinical comparison group (n = 45) completed the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) and the Brief Assessment of Cognition in Schizophrenia (BACS). The patient group also completed the Positive and Negative Syndromes Scale (PANSS), the Birchwood Insight Scale (IS), and the Hospital Anxiety and Depression Scale (HADS). RESULTS: The BACS and SSTICS scores were associated in the non-clinical comparison group, but not in the patient group. In the patient group worse subjective cognition was associated positively with good insight, greater dysphoria and greater positive symptoms. Linear regression revealed that, once other variables had been accounted for, dysphoria (HADS anxiety and depression factor) was the only significant predictor of SSTICS scores. CONCLUSIONS: Subjective cognitive impairment in patients with psychosis in the absence of formal testing should not be taken as evidence of impaired cognitive functioning. Mood should be investigated when patients present with subjective cognitive complaints.
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The HADS has sufficiently high internal consistency in a sample of individuals diagnosed with schizophrenia (α = 0.86 and 0.83).
“Sellwood et al. (2013) have recently demonstrated that the internal consistency of the anxiety and depression sub-scales of the HADS in a sample of individuals diagnosed with schizophrenia were sufficiently high (α = 0.86 and α = 0.83 respectively).”
From Acceptance and Commitment Therapy for depression following psychosis: An examination of clinically significant change (2015) · cites this paper as Sellwood et al. (2013)
The Methods > Measures section reports HADS Cronbach’s alpha values of 0.86 for anxiety and 0.83 for depression, as claimed. However, Methods > Clinical participants says these values came from a schizophrenia-spectrum patient sample that included people with schizoaffective disorder and other psychoses, not exclusively individuals diagnosed with schizophrenia. No page numbers are available in our copy. (LLM, conf=0.88)
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- Authors
- Sellwood, W., Morrison, A. P., Beck, R., Heffernan, S., Law, H., & Bentall, R. P.
- Affiliations
- University of Liverpool (GB)
- University of Manchester (GB)
- Lancaster University (GB)
- Corresponding author
- Sellwood, William
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-12-20
- Volume
- 8
- Issue
- 12
- Pages
- e83774
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3869800
- OpenAlex
- W2002203744
- Cited by
- 46
- References
- 39
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 4 · 2023: 4 · 2022: 2 · 2021: 7 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 2 · 2014: 4
- FWCI
- 2.13
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lancaster EPrints (Lancaster University) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- University of Pittsburgh
- National Institute for Health and Care Research (RP-PG-0606-1086)
- Programme Grants for Applied Research
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- subjective cognitive complaints, schizophrenia, insight, dysphoria, positive symptoms, cognitive impairment, mood, schizophrenia spectrum disorders, Brief Assessment of Cognition in Schizophrenia
- MeSH terms
- Adolescent, Adult, Aged, Anxiety, Cognition, Depression, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, Young Adult
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