title: Adaptation and validation of the "cognitive complaints in bipolar disorder rating assessment" (COBRA) in Chinese bipolar patients.
abstract: BACKGROUND
  There is no specific instrument available to measure cognitive deficits as reported by bipolar patients in China. Therefore, if discrepancies between bipolar patients' reports and the results of neuropsychological tests which have been described in other countries existing or not in Chinese bipolar disorder patients have not been known yet. And it is completely blank about the subjective cognition of these Chinese bipolar patients.
  
  
  OBJECTIVE
  The aim of the study is to revise and validate a specific, user-friendly, brief instrument named the "cognitive complaints in bipolar disorder rating assessment" (COBRA) into Chinese version.
  
  
  METHODS
  The total sample (N=255) included 125 bipolar disorder patients and 130 healthy controls. The psychometric properties of the COBRA (e.g. internal consistency, retest reliability, discriminative validity, concurrent validity, content validity, item analysis, confirmatory factor analysis, ROC curve and feasibility) were analyzed.
  
  
  RESULTS
  The Chinese version of the COBRA had very high internal consistency (Cronbach's alpha=0.905) and retest reliability (ICC=0.902). Confirmatory factor analysis validated the one-factor model and the cut-off value to discriminate the patients and controls was 11.Bipolar patients experienced greater cognitive complaints compared to control group suggesting a discriminative validity of the instrument. No significant correlation was found between the COBRA and the total Montreal Cognitive Assessment Scale (MoCA), except for single measures related to executive function (phonemic fluency, p=0.045), verbal memory (delayed recall, p=0.004).
  
  
  CONCLUSIONS
  Cross-sectional design, no specific or unspecific but reliable instrument in Chinese to assess subjective cognitive difficulties in mental disorders for criterion validity or convergent validity analysis.
  
  
  CONCLUSIONS
  The Chinese version of the COBRA showed to be a simple and reliable instrument to assess subjective cognitive complaints in Chinese bipolar patients.
authors.affiliation: Nursing School of Central South University, Hunan province 410013, China. Electronic address: 757462438@qq.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Nursing School of Central South University, Hunan province 410013, China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Lin
authors.affiliation: Nursing School of Central South University, Hunan province 410013, China.
authors.forename: Qingyan
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen 361012, China.
authors.forename: Dali
authors.initials: D
authors.lastname: Lu
authors.affiliation: Nursing School of Central South University, Hunan province 410013, China. Electronic address: tangsyuan@126.com.
authors.forename: Siyuan
authors.initials: S
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology*; D002681:China; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011594:Psychometrics; D015203:Reproducibility of Results; D055815:Young Adult
keywords: Bipolar disorder; Reliability; Subjective cognitive impairment; Validity