Identifying attentional deficits in people with first-episode psychosis with the Scale for the Assessment of Negative Symptoms attention subscale: is it possible?
OBJECTIVE
The aim of this study was to examine the correspondence between clinical ratings of inattention problems in the early course of a psychotic disorder and concurrent neuropsychological data for sustained attention and speed of processing/executive functioning (SP/EF) derived from a comprehensive neuropsychological test battery.


METHODS
A sample of 131 patients with first-episode psychosis (FEP) was clinically rated after clinical stabilization with the attention subscale of the Scale for the Assessment of Negative Symptoms (SANS) and a completed neuropsychological test battery, which included measurements of sustained attention and SP/EF. To test the associations of the clinical ratings and objective data, correlations and regression analyses were conducted.


RESULTS
Clinical ratings of inattention showed only weak correlations with the global score of SP/EF and with the clinical ratings of negative symptoms (ρ < 0.25). None of the independent variables entered in the logistic regression model were significant (all P values > .05). Percentages of agreement between clinical judgment and neuropsychological measures were unacceptably low (ranged from 53% to 68%). κ values indicate only slight agreement (κ < 0.2).


CONCLUSIONS
Clinical ratings based on the SANS attention subscale do not reliably match neuropsychological test measures of attention or other related cognitive processes in FEP. Even for those cognitive domains more pronouncedly impaired, mental health professionals will likely need to rely on psychometric testing or, alternatively, specific guidelines and also, probably, to collect data from different sources to adequately identify cognitive impairments.
Psychiatry Research Unit of Cantabria, CIBERSAM, University Hospital Marqués de Valdecilla, Santander, Spain. cgblanch@terra.es
César
C
González-Blanch
Amador
A
Priede
José Manuel
JM
Rodríguez-Sánchez
Rocío
R
Perez-Iglesias
José Luis
JL
Vázquez-Barquero
Benedicto
B
Crespo-Facorro
D000328:Adult; D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology