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Measuring Cognitive Impairments Associated With Schizophrenia in Clinical Practice: Overview of Current Challenges and Future Opportunities
Schizophrenia Bulletin ( IF 5.3 ) Pub Date : 2024-08-01 , DOI: 10.1093/schbul/sbae051
Keith H Nuechterlein 1 , Henry Nasrallah 2 , Dawn Velligan 3
Affiliation  

Background Cognitive impairment associated with schizophrenia (CIAS) negatively impacts daily functioning, quality of life, and recovery, yet effective pharmacotherapies and practical assessments for clinical practice are lacking. Despite the pivotal progress made with establishment of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) for clinical research, implementation of the full MCCB is too time-consuming and cost-ineffective for most clinicians in clinical practice. Study Design Here we discuss current assessments in relation to delivery format (interview-based and performance-based), validity, ease of use for clinicians and patients, reliability/reproducibility, cost-effectiveness, and suitability for clinical implementation. Key challenges and future opportunities for improving cognitive assessments are also presented. Study results Current assessments that require 30 min to complete would have value in clinical settings, but the associated staff training and time required might preclude their application in most clinical settings. Initial profiling of cognitive deficits may require about 30 min to assist in the selection of evidence-based treatments; follow-up monitoring with brief assessments (10–15 min in duration) to detect treatment-related effects on global cognition may complement this approach. Guidance on validated brief cognitive tests for the strategic monitoring of treatment effects on CIAS is necessary. Conclusions With increased advancements in technology-based and remote assessments, development of validated formats of remote and in-person assessment, and the necessary training models and infrastructure required for implementation, are likely to be of increasing clinical relevance for future clinical practice.

中文翻译:


在临床实践中测量与精神分裂症相关的认知障碍:当前挑战和未来机遇概述



背景 与精神分裂症相关的认知障碍 (CIAS) 对日常功能、生活质量和恢复产生负面影响,但缺乏有效的药物治疗和临床实践的实践评估。尽管在建立用于临床研究的改善精神分裂症认知的测量和治疗研究 (MATRICS) 共识认知电池 (MCCB) 方面取得了关键进展,但对于临床实践中的大多数临床医生来说,实施完整的 MCCB 太耗时且成本效益低下。研究设计 在这里,我们讨论了与交付形式(基于访谈和基于绩效)、有效性、临床医生和患者的易用性、可靠性/再现性、成本效益和临床实施的适用性相关的当前评估。还提出了改进认知评估的主要挑战和未来机遇。研究结果 当前需要 30 分钟才能完成的评估在临床环境中具有价值,但相关的员工培训和所需的时间可能会妨碍它们在大多数临床环境中的应用。认知缺陷的初步分析可能需要大约 30 分钟来帮助选择循证治疗;通过简短评估(持续时间 10-15 分钟)进行随访监测以检测治疗相关对整体认知的影响,可能会补充这种方法。有必要指导经过验证的简短认知测试,以战略监测对 CIAS 的治疗效果。 结论 随着基于技术和远程评估的进步,经过验证的远程和面对面评估格式的开发,以及实施所需的必要培训模型和基础设施,可能会与未来的临床实践越来越相关。
更新日期:2024-08-01
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