Sensitivity and applicability of the Brazilian version of the Brief Assessment of Cognition in Schizophrenia (BACS)

Salgado, João Vinícius; Carvalhaes, Carolina F. Richards; Pires, Annelise de Matos; Neves, Maila de Castro L. das; Cruz, Breno Fiúza; Cardoso, Clareci Silva; Lauar, Helio; Teixeira, Antonio Lúcio; Keefe, Richard S.E.

doi:10.1590/S1980-57642008DN10300007

Abstract

Cognitive assessment in schizophrenia has traditionally used batteries that are long and complex or differ widely in their content. The Brief Assessment of Cognition in Schizophrenia (BACS) has been developed to cover the main cognitive deficits of schizophrenia as well as to be easily and briefly administered, portable, sensitive and reliable. Objectives: To investigate the applicability and sensitivity of the Brazilian Version of the BACS (Brazilian-BACS). Methods: Performance of 20 stable patients with schizophrenia on the Brazilian-BACS was compared to 20 matched healthy controls. Results: Applying the Brazilian-BACS required 43.4±8.4 minutes for patients and 40.5±5.7 minutes for controls (p=0.17). All tests demonstrated significant differences between controls and patients (P<0.01). Pearson's correlation analysis and Cronbach's a evidenced a high internal consistency for patient performance. The cognitive deficit in the patients was approximately 1.5 standard deviations below controls. These results were consistent with those reported in the validation of the original version and in meta-analyses of similar studies. Conclusions: The Brazilian-BACS displayed good applicability and sensitivity in assessing the major cognitive constructs that are impaired in schizophrenia. Thus, the Brazilian-BACS seems to be a promising tool for assessing cognition in patients with schizophrenia in Brazil.

Key words:
schizophrenia; cognition; neuropsychological assessment; BACS.

Resumo

A avaliação cognitiva na esquizofrenia tem utilizado tradicionalmente baterias longas e complexas ou que variam significativamente em seu conteúdo. A "Brief Assessment of Cognition in Schizophrenia" (BACS) foi desenvolvida para cobrir os principais déficits cognitivos na esquizofrenia, para ser de fácil e breve aplicação, assim como portátil, sensível e confiável. Objetivos: Investigar a aplicabilidade e a sensibilidade da versão brasileira da BACS (Brazilian-BACS). Métodos: O desempenho de 20 pacientes estáveis com esquizofrenia na Brazilian-BACS foi comparado ao de 20 controles saudáveis pareados. Resultados: A aplicação da Brazilian-BACS exigiu 43.4±8.4 minutos nos pacientes e 40.5±5.7 minutos nos controles (p=0.17). Todos os testes foram significativamente diferentes entre pacientes e controles (P<0.01). A correlação de Pearson e o alfa de Cronbach evidenciaram alto grau de consistência interna no desempenho dos pacientes. O déficit cognitivo nos pacientes foi cerca de 1,5 desvio-padrão menor do que nos controles. Esses resultados são consistentes com os relatados na validação da versão original e em meta-análises de estudos similares. Conclusões: A Brazilian-BACS mostrou boas aplicabilidade e sensibilidade na investigação dos principais domínios cognitivos comprometidos na esquizofrenia. Portanto, a Brazilian-BACS mostra-se um instrumento promissor no estudo da cognição de pacientes com esquizofrenia no Brasil.

Palavras-chave:
esquizofrenia; cognição; avaliação neuropsicológica; BACS.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

References

¹
Green MF, Kern RS, Braff DL, Mintz J. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the ''right stuff''. Schizophr Bull 2000;26:119-136.
²
Heinrichs, RW, Zakzanis, KK. Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 1998;12:426-445.
³
Keefe RS, Goldberg TE, Harvey PD, Gold JM, Poe MP, Coughenour L. The Brief Assessment of Cognition in Schizophrenia: reliability, sensitivity, and comparison with a standard neurocognitive battery. Schizophr Res 2004;68:283-297.
⁴
Robbins TW, James M, Owen AM, Sahakian BJ, McInnes L, Rabbitt PM. A neural systems approach to the cognitive psychology of aging: studies with CANTAB on a large sample of the normal elderly population. In: Rabbitt, PM, editor. Methodology of frontal and executive function. Hove: Lawrence Erlbaum Associates; 1996:215-238.
⁵
Cogtest plc. Cogtest(tm): Computerised cognitive battery for clinical trials. 2002. Retrieved from http://www.cogtest.com
» http://www.cogtest.com
⁶
Randolph C. Repeatable battery for the assessment of neuropsychological status. San Antonio: Psychological Corp.; 1998.
⁷
Gold JM, Queern C, Iannone VN, Buchanan RW. Repeatable battery for the assessment of neuropsychological status as a screening test in schizophrenia: I. Sensitivity, reliability, and validity. Am J Psychiatry 1999;156:1944-1950.
⁸
Hobart MP, Goldberg R, Bartko JJ, Gold JM. Repeatable battery for the assessment of neuropsychological status as a screening test in schizophrenia: II. Convergent/discriminant validity and diagnostic group comparisons. Am J Psychiatry 1999;156:1951-1957.
⁹
Amorim P. Mini International Neuropsychiatric Interview (MINI): validação de entrevista breve para diagnóstico de transtornos mentais. Rev Bras Psiquiatr 2000;22:106-115.
¹⁰
Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261-276.
¹¹
Tonelli H, Tonelli D, Poiani GR, Vital MA, Andreatini R. Reliability and clinical utility of a Portuguese version of the Abnormal Involuntary Movements Scale (AIMS) for tardive dyskinesia in Brazilian patients. Braz J Med Biol Res 2003;36:511-514.
¹²
Vallerand R. Vers une methodologique de validation transculturelle de questionnaires psychologiques. Can Psychol 1989;30:662-680.
¹³
Harvey PD, Keefe RS. Cognitive impairment in schizophrenia and implications atypical neuroleptic treatment. CNS Spectr 1997;2:1-11.
¹⁴
Keefe RS, Seidman LJ, Christensen BK, et al. Comparative effect of atypical and conventional antipsychotic drugs on neurocognition in first-episode psychosis: a randomized, double-blind trial of olanzapine versus low doses of haloperidol. Am J Psychiatry. 2004;161:985-995.
¹⁵
Heaton RK, Gladsjo JA, Palmer BW, Kuck J, Marcotte TD, Jeste DV. Stability and course of neuropsychological deficits in schizophrenia. Arch Gen Psychiatry 2001;58:24-32.

Publication Dates

Publication in this collection
Jul-Sep 2007

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] ¹
Green MF, Kern RS, Braff DL, Mintz J. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the ''right stuff''. Schizophr Bull 2000;26:119-136.

[2] ²
Heinrichs, RW, Zakzanis, KK. Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 1998;12:426-445.

[3] ³
Keefe RS, Goldberg TE, Harvey PD, Gold JM, Poe MP, Coughenour L. The Brief Assessment of Cognition in Schizophrenia: reliability, sensitivity, and comparison with a standard neurocognitive battery. Schizophr Res 2004;68:283-297.

[4] ⁴
Robbins TW, James M, Owen AM, Sahakian BJ, McInnes L, Rabbitt PM. A neural systems approach to the cognitive psychology of aging: studies with CANTAB on a large sample of the normal elderly population. In: Rabbitt, PM, editor. Methodology of frontal and executive function. Hove: Lawrence Erlbaum Associates; 1996:215-238.

[5] ⁵
Cogtest plc. Cogtest(tm): Computerised cognitive battery for clinical trials. 2002. Retrieved from http://www.cogtest.com
» http://www.cogtest.com

[6] ⁶
Randolph C. Repeatable battery for the assessment of neuropsychological status. San Antonio: Psychological Corp.; 1998.

[7] ⁷
Gold JM, Queern C, Iannone VN, Buchanan RW. Repeatable battery for the assessment of neuropsychological status as a screening test in schizophrenia: I. Sensitivity, reliability, and validity. Am J Psychiatry 1999;156:1944-1950.

[8] ⁸
Hobart MP, Goldberg R, Bartko JJ, Gold JM. Repeatable battery for the assessment of neuropsychological status as a screening test in schizophrenia: II. Convergent/discriminant validity and diagnostic group comparisons. Am J Psychiatry 1999;156:1951-1957.

[9] ⁹
Amorim P. Mini International Neuropsychiatric Interview (MINI): validação de entrevista breve para diagnóstico de transtornos mentais. Rev Bras Psiquiatr 2000;22:106-115.

[10] ¹⁰
Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261-276.

[11] ¹¹
Tonelli H, Tonelli D, Poiani GR, Vital MA, Andreatini R. Reliability and clinical utility of a Portuguese version of the Abnormal Involuntary Movements Scale (AIMS) for tardive dyskinesia in Brazilian patients. Braz J Med Biol Res 2003;36:511-514.

[12] ¹²
Vallerand R. Vers une methodologique de validation transculturelle de questionnaires psychologiques. Can Psychol 1989;30:662-680.

[13] ¹³
Harvey PD, Keefe RS. Cognitive impairment in schizophrenia and implications atypical neuroleptic treatment. CNS Spectr 1997;2:1-11.

[14] ¹⁴
Keefe RS, Seidman LJ, Christensen BK, et al. Comparative effect of atypical and conventional antipsychotic drugs on neurocognition in first-episode psychosis: a randomized, double-blind trial of olanzapine versus low doses of haloperidol. Am J Psychiatry. 2004;161:985-995.

[15] ¹⁵
Heaton RK, Gladsjo JA, Palmer BW, Kuck J, Marcotte TD, Jeste DV. Stability and course of neuropsychological deficits in schizophrenia. Arch Gen Psychiatry 2001;58:24-32.

Brasil