Psychiatric disability as mediator of the neurocognition-functioning link in schizophrenia spectrum disorders: SEM analysis using the Evaluation of Cognitive Processes involved in Disability in Schizophrenia (ECPDS) scale
Schizophrenia Research. 2018-11-01; 201: 196-203
DOI: 10.1016/j.schres.2018.06.021
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1. Schizophr Res. 2018 Nov;201:196-203. doi: 10.1016/j.schres.2018.06.021. Epub
2018 Jun 23.
Psychiatric disability as mediator of the neurocognition-functioning link in
schizophrenia spectrum disorders: SEM analysis using the Evaluation of Cognitive
Processes involved in Disability in Schizophrenia (ECPDS) scale.
Roux P(1), Urbach M(2), Fonteneau S(2), Berna F(3), Brunel L(4), Capdevielle
D(5), Chereau I(6), Dubreucq J(7), Faget-Agius C(8), Fond G(9), Leignier S(7),
Perier CC(7), Richieri R(8), Schneider P(3), Schürhoff F(4), Tronche AM(6),
Yazbek H(5), Zinetti-Bertschy A(3); FondaMental Advanced Centers of Expertise in
Schizophrenia (FACE-SCZ) Collaborators; Passerieux C(2), Brunet-Gouet E(2).
Collaborators: Andrianarisoa M(10), Aouizerate B(11), Bazin N(12), Berna F(13),
Blanc O(14), Brunel L(10), Bulzacka E(10), Capdevielle D(15), Chereau-Boudet
I(14), Chesnoy-Servanin G(16), Danion J(13), D’Amato T(16), Deloge A(17),
Delorme C(18), Denizot H(14), Dorey JM(16), Dubertret C(19), Dubreucq J(18),
Faget C(20), Fluttaz C(18), Fond G(21), Fonteneau S(12), Gabayet F(18),
Giraud-Baro E(18), Lacelle D(14), Lançon C(20), Laouamri H(21), Leboyer M(10),
Le Gloahec T(10), Le Strat Y(19), Llorca(14), Mallet J(19), Metairie E(20),
Misdrahi D(17), Offerlin-Meyer I(13), Passerieux C(12), Peri P(20), Pires S(14),
Portalier C(19), Ramet L(12), Rey R(16), Roman C(18), Schandrin A(22), Schürhoff
F(10), Tessier A(17), Tronche A(14), Urbach M(12), Vaillant F(20), Vehier A(16),
Vidailhet P(13), Vilà E(17), Yazbek H(15), Zinetti-Bertschy A(13).
Author information:
(1)Fondation FondaMental, Créteil, France; Department of Adult Psychiatry,
Versailles Hospital, Le Chesnay, France; HandiRESP Laboratory, EA4047, Health
Sciences Department Simone Veil, University of Versailles
Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France. Electronic address:
.
(2)Fondation FondaMental, Créteil, France; Department of Adult Psychiatry,
Versailles Hospital, Le Chesnay, France; HandiRESP Laboratory, EA4047, Health
Sciences Department Simone Veil, University of Versailles
Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France.
(3)Fondation FondaMental, Créteil, France; Strasbourg University Hospital,
INSERM U1114, Strasbourg Federation of Translational Psychiatry, Strasbourg,
France.
(4)Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry
team, Université Paris-Est Créteil (UPEC), AP-HP, DHU Pe-PSY, Department of
Adult Psychiatry, University Hospitals H Mondor, Créteil, France.
(5)Fondation FondaMental, Créteil, France; Academic Department of Adult
Psychiatry, La Colombière Hospital, CHU Montpellier, University of Montpellier
1, INSERM 1061, Montpellier, France.
(6)Fondation FondaMental, Créteil, France; CMP B, Clermont-Ferrand University
Hospital, EA 7280, Faculty of Medicine, Auvergne University, Clermont-Ferrand,
France.
(7)Fondation FondaMental, Créteil, France; Psychosocial Rehabilitation Reference
Centre, Alpes Isère Hospital, Grenoble, France.
(8)Fondation FondaMental, Créteil, France; Academic Department of Psychiatry
(AP-HM), Sainte-Marguerite University Hospital, Marseille, France.
(9)Fondation FondaMental, Créteil, France.
(10)INSERM U955, Translational Psychiatry Team, DHU Pe-PSY, Schizophrenia Centre
of Expertise, Psychiatry and Addictions Department, Henri Mondor University
Hospitals, Paris Est University, 40 rue de Mesly, 94000 Créteil, France;
FondaMental Foundation, France.
(11)Department of Adult Psychiatry, Charles Perrens Hospital, F-33076 Bordeaux,
France; FondaMental Foundation, France; University of Bordeaux, France; INSERM,
Magendie Neurocentre – Pathophysiology of neural plasticity, U862, F-33000
Bordeaux, France.
(12)Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France;
FondaMental Foundation, France; HandiRESP Laboratory, EA4047, Health Sciences
Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines,
Montigny-le-Bretonneux, France.
(13)Strasbourg University Hospital, University of Strasbourg, INSERM U1114,
Federation of Translational Psychiatry, Strasbourg, France; FondaMental
Foundation, France.
(14)Clermont-Ferrand University Hospital, EA 7280 Auvergne University, BP 69
63003 Clermont-Ferrand Cedex 1, France; FondaMental Foundation, France.
(15)University Department of Adult Psychiatry, La Colombiere Hospital, CHRU
Montpellier, University of Montpellier 1, INSERM 1061, Montpellier, France;
FondaMental Foundation, France.
(16)University Claude Bernard Lyon 1, Le Vinatier Hospital Pole Est BP 300 39 –
95 bd Pinel, 69678 Bron Cedex, France; FondaMental Foundation, France.
(17)Department of Adult Psychiatry, Charles Perrens Hospital, F-33076 Bordeaux,
France; FondaMental Foundation, France; University of Bordeaux, France; CNRS UMR
5287-INCIA, France.
(18)Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital,
Grenoble, France; FondaMental Foundation, France.
(19)AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, INSERM
U894, Paris Diderot University, Sorbonne Paris Cité, Faculty of Medicine,
France; FondaMental Foundation, France.
(20)Department of Psychiatry (AP-HM), Sainte-Marguerite University Hospital,
Marseille, France; FondaMental Foundation, France.
(21)FondaMental Foundation, France.
(22)Department of Adult Psychiatry, University Hospital of Nimes, France;
FondaMental Foundation, France.
The functional outcome in schizophrenia spectrum disorders is affected by
multiple factors such as cognitive performance and clinical symptoms.
Psychiatric disability may be another important determinant of functional
outcome. The purpose of this study was to test whether schizophrenia symptoms
and psychiatric disability mediated the association between cognition and
functioning. Between April 2013 and July 2017, we included 108
community-dwelling adults with stable schizophrenia spectrum disorder in a
multicenter study. Psychiatric disability was assessed with the Evaluation of
Cognitive Processes involved in Disability in Schizophrenia (ECPDS) scale by
relatives of patients. ECPDS focused on the broad array of motivational,
neurocognitive, sociocognitive, and metacognitive impairments that result in
activity restrictions. We used a battery of tests to assess seven cognition
domains (processing speed, attention/vigilance, working, verbal and visual
memory, reasoning and problem solving, and executive functioning) and
cross-sectional structural equation modeling (SEM) for the mediation analyses.
We estimated the one-year temporal stability of ECPDS scores in 45 participants.
The model provided showed good fit and explained 43.9% of the variance in
functioning. The effect of neurocognition on functioning was fully mediated by
symptoms (proportion mediated: 36.5%) and psychiatric disability (proportion
mediated: 31.3%). The ECPDS score had acceptable one-year temporal stability.
The ECPDS scale has satisfactory psychometric properties, and shows significant
convergence with neurocognition and functioning, suggesting a role for this tool
in the routine evaluation of cognitive remediation needs. Our model validates
psychiatric disability as a crucial step from cognitive impairment to restricted
participation in life situations.
Copyright © 2018 Elsevier B.V. All rights reserved.
DOI: 10.1016/j.schres.2018.06.021
PMID: 29941294 [Indexed for MEDLINE]