Immediate post performance judgements about cognitive performance in schizophrenia and bipolar disorder: associations with test performance and subjective overall judgments regarding abilities

ABSTRACT

Introduction:

The study explored associations between the accuracy of post assessment judgements of cognitive performance with global self-assessments of psychosocial functioning compared to evaluations generated by observers in schizophrenia and bipolar disorder.

Methods:

An abbreviated cognitive assessment based on the MATRICS Consensus Cognitive Battery was administered to 122 individuals with schizophrenia and 113 with bipolar disorder. They provided self-estimates of their performance after each subtest. In addition, self-reports on cognition, social cognition, and everyday functioning were collected and compared to observer ratings.

Results:

Both groups overestimated their cognitive function, but in bipolar disorder, there was 30% shared variance between task performance and self-rated task performance (vs. 5% in schizophrenia). Significant correlations were found between self-reported everyday outcomes and both actual and self-assessed performance. In schizophrenia, immediate judgements were only related to self-rated functioning, not to observer rated functioning. In bipolar disorder, impairments in self-assessment of performance correlated with observer ratings of cognitive ability, which was not observed in schizophrenia.

Conclusions:

While both groups showed correlations between cognitive performance and introspective accuracy, individuals with bipolar disorder showed higher accuracy in assessing their cognitive performance and other outcomes. Notably, impairments in introspective accuracy were associated with observer-rated functioning exclusively in bipolar disorder.

KEYWORDS:

• Neurocognition
• introspective accuracy
• schizophrenia
• bipolar disorder
• functioning

Conflict of interest statement

Dr. Raeanne C. Moore is a co-founder of KeyWise AI, Inc. and a consultant for NeuroUX. Dr. Harvey has received consulting fees or travel reimbursements from Alkermes, Bio Excel, Boehringer Ingelheim, Intra-Cellular Therapies, Minerva Pharma, Otsuka America, Regeneron, Roche Pharma and Sunovion Pharma. He receives royalties from the Brief Assessment of Cognition in Schizophrenia and the MATRICS Consensus Battery. He has a research grant from Takeda and from the Stanley Medical Research Foundation. He is chief scientific officer of iFunction, Inc. Dr. Pinkham has served as a consultant for Roche Pharma. The other authors have no potential Biomedical Conflicts of Interest.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [ND], upon reasonable request.

Additional information

Funding

This research was supported by NIMH [grant number RO1MH112620] to Dr. Pinkham.