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      General description of cognitive deficits in schizophrenia and assessment tools in Lebanon: A scoping review

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          Abstract

          Many cognitive functions are affected in schizophrenia patients, particularly memory, attention, motor skills, executive function, and social cognition. Cognitive assessment is one of the best indicators of the functional and social prognosis of schizophrenic patients. In Lebanon, no study has yet examined the assessment of cognitive functions in patients with neurological or psychiatric diseases. This review aims to provide an overview of the cognitive profiles of schizophrenia and describe the different cognitive tests used in Lebanon. The MEDLINE/PubMed database was used to conduct a literature review covering all studies related to cognition in psychosis patients from 1990 until March 2021. This screening resulted in 97 articles focused on cognition in psychiatric patients or cognitive tests in schizophrenia and required an in-depth analysis. The majority of measures developed to evaluate cognition in patients with schizophrenia were from Western countries, most of which are long and complex and may require several hours to administer. The number of neuropsychological tests available in Arab countries is unknown, although it is likely to be limited compared to what is available in Western countries. In Lebanon, some neuropsychological batteries have been locally used to assess cognition without being translated and validated to be adapted to the Lebanese sociocultural context. Clinicians in Lebanon underestimate the extent of cognitive impairment in schizophrenia patients as they have limited options, using untranslated tests or using translations that have not been validated. Future studies should target the development and adaptation of instruments that predict and measure cognition and functional ability.

          Highlights

          • Many cognitive functions are generally impaired in patients with schizophrenia

          • The number of neuropsychological tests available in Arab countries is unknown

          • In Lebanon, some neuropsychological batteries have been used to assess cognition without being translated and validated

          • Few studies conducted in Lebanon have used neurocognitive tests among schizophrenia.

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          Most cited references88

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          The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.

          To develop a 10-minute cognitive screening tool (Montreal Cognitive Assessment, MoCA) to assist first-line physicians in detection of mild cognitive impairment (MCI), a clinical state that often progresses to dementia. Validation study. A community clinic and an academic center. Ninety-four patients meeting MCI clinical criteria supported by psychometric measures, 93 patients with mild Alzheimer's disease (AD) (Mini-Mental State Examination (MMSE) score > or =17), and 90 healthy elderly controls (NC). The MoCA and MMSE were administered to all participants, and sensitivity and specificity of both measures were assessed for detection of MCI and mild AD. Using a cutoff score 26, the MMSE had a sensitivity of 18% to detect MCI, whereas the MoCA detected 90% of MCI subjects. In the mild AD group, the MMSE had a sensitivity of 78%, whereas the MoCA detected 100%. Specificity was excellent for both MMSE and MoCA (100% and 87%, respectively). MCI as an entity is evolving and somewhat controversial. The MoCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE.
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            "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.

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              The Modified Mini-Mental State (3MS) examination.

              E Teng, H Chui (1987)
              The Mini-Mental State (MMS) examination is a widely used screening test for dementia. The Modified Mini-Mental State (3MS) incorporates four added test items, more graded scoring, and some other minor changes. These modifications are designed to sample a broader variety of cognitive functions, cover a wider range of difficulty levels, and enhance the reliability and the validity of the scores. The 3MS retains the brevity, ease of administration, and objective scoring of the MMS but broadens the range of scores from 0-30 to 0-100. Greater sensitivities of the 3MS over the MMS are demonstrated with the pentagon item drawn by 249 patients. A summary form for administration and scoring that can generate both the MMS and the 3MS scores is provided so that the examiner can maintain continuity with existing data and can obtain a more informative assessment.
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                Author and article information

                Contributors
                Journal
                Schizophr Res Cogn
                Schizophr Res Cogn
                Schizophrenia Research: Cognition
                Elsevier
                2215-0013
                21 May 2021
                September 2021
                21 May 2021
                : 25
                : 100199
                Affiliations
                [a ]INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
                [b ]Pôle Universitaire de Psychiatrie de l'Adulte, de l'Agée et d'Addictologie, Centre Hospitalier Esquirol, 87000 Limoges, France
                [c ]Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
                [d ]INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
                [e ]Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
                [f ]University of Nicosia Medical School, Nicosia, Cyprus
                [g ]Centre Mémoire de Ressources et de Recherche du Limousin, Centre Hospitalier Esquirol, 87000 Limoges, France
                Author notes
                [* ]Corresponding author at: Psychiatric Hospital of the Cross, P.O. Box 60096, Jall-Eddib, Lebanon. Chadia.haddad@ 123456inspect-lb.org
                [1]

                Last co-authors.

                Article
                S2215-0013(21)00006-8 100199
                10.1016/j.scog.2021.100199
                8163972
                bd694bff-3890-4977-816a-0a2b93e40b4d
                © 2021 Published by Elsevier Inc.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 9 April 2021
                : 10 May 2021
                : 11 May 2021
                Categories
                Review Article

                cognition,schizophrenia,neuropsychological tests,cognitive impairment,psychosis

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