Subjective cognitive impairment in people with early psychosis: relationship with objective cognitive impairment and clinical symptoms

Abstract

Introduction Subjective cognitive impairment (SCI) among individuals with early psychosis is under-recognized and under-studied. Yet, SCI is as important as objective impairment to be understood, since it assesses cognition difficulties in everyday, real-life situations from a personal perspective and is therefore an essence of individualise medicine. Objectives This study aims to explore the associations between the objective and subjective measures of cognitive impairments and to identify factors contributing to SCI among people with early psychosis. Methods Participants were 63 females (mean age=24.41 years old, SD=8.15) diagnosed with early psychosis within 5 years. They completed a battery of neuropsychological tests assessing on a range of cognitive functions. These included memory (HKLLT, Digit SPAN), attention (Letter Cancellation test), and executive functions (WAIS, STROOP). The Subjective cognitive impairment Scale (SCIS) was also used to assess their perceived cognitive decline. Psychotic symptoms (PANSS) and depression (CDS) were also assessed. Results SCIS was not correlated with any of the objective cognitive tests results (p>.05). It was positively correlated with depression (r= .55, p<.001) and positive symptoms (r= .49, p<.001). A hierarchical multiple regression model reveals that positive symptoms and depression together explained 31.3% of the total variance in SCIS and only depression significantly predicted subjective cognitive impairment in our participants (β=.4, p<.01). Conclusions Subjective feeling of cognitive impairment may be a result of catastrophization associated with depression secondary to the psychosis. Treatments should not only focus on symptomatic remission and cognitive training, but also place emphasize on improving affects of individuals with early psychosis.