Assessing cognition in people with severe mental disorders in low- and middle-income countries: a systematic review of assessment measures

Yohannes Gebreegziabhere Haile; Kassahun Habatmu; Andualem Derese; Hetta Gouse; Stephen M Lawrie; Matteo Cella; Atalay Alem

doi:10.1007/s00127-021-02120-x

Assessing cognition in people with severe mental disorders in low- and middle-income countries: a systematic review of assessment measures

Yohannes Gebreegziabhere Haile, Kassahun Habatmu, Andualem Derese, Hetta Gouse, Stephen M Lawrie, Matteo Cella, Atalay Alem

Research output: Contribution to journal › Review article › peer-review

9 Citations (Scopus)

Abstract

BACKGROUND: Cognitive difficulties are common in people with severe mental disorders (SMDs) and various measures of cognition are of proven validity. However, there is a lack of systematic evidence regarding the psychometric properties of these measures in low- and middle-income countries (LMICs).

OBJECTIVE: To systematically review the psychometric properties of cognitive measures validated in people with SMDs in LMICs.

METHODS: We conducted a systematic review of the literature by searching from four electronic databases. Two authors independently screened studies for their eligibility. Measurement properties of measures in all included studies were extracted. All eligible measures were assessed against criteria set for clinical and research recommendations. Results are summarized narratively and measures were grouped by measurement type and population.

RESULTS: We identified 23 unique measures from 28 studies. None of these was from low-income settings. Seventeen of the measures were performance-based. The majority (n = 16/23) of the measures were validated in people with schizophrenia. The most commonly reported measurement properties were: known group, convergent, and divergent validity (n = 25/28). For most psychometric property, studies of methodological qualities were found to be doubtful. Among measures evaluated in people with schizophrenia, Brief Assessment of Cognition in Schizophrenia, Cognitive Assessment Interview, MATRICS Consensus Cognitive Battery, and CogState Schizophrenia Battery were with the highest scores for clinical and research recommendation.

CONCLUSIONS: Studies included in our review provide only limited quality evidence and future studies should consider adapting and validating measures using stronger designs and methods. Nonetheless, validated assessments of cognition could help in the management and allocating therapy in people with SMDs in LMICs.

Original language	English
Journal	Social Psychiatry and Psychiatric Epidemiology
DOIs	https://doi.org/10.1007/s00127-021-02120-x
Publication status	E-pub ahead of print - 18 Jun 2021

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10.1007/s00127-021-02120-x

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@article{5951bfce65d646dcb2361434279798a2,

title = "Assessing cognition in people with severe mental disorders in low- and middle-income countries: a systematic review of assessment measures",

abstract = "BACKGROUND: Cognitive difficulties are common in people with severe mental disorders (SMDs) and various measures of cognition are of proven validity. However, there is a lack of systematic evidence regarding the psychometric properties of these measures in low- and middle-income countries (LMICs).OBJECTIVE: To systematically review the psychometric properties of cognitive measures validated in people with SMDs in LMICs.METHODS: We conducted a systematic review of the literature by searching from four electronic databases. Two authors independently screened studies for their eligibility. Measurement properties of measures in all included studies were extracted. All eligible measures were assessed against criteria set for clinical and research recommendations. Results are summarized narratively and measures were grouped by measurement type and population.RESULTS: We identified 23 unique measures from 28 studies. None of these was from low-income settings. Seventeen of the measures were performance-based. The majority (n = 16/23) of the measures were validated in people with schizophrenia. The most commonly reported measurement properties were: known group, convergent, and divergent validity (n = 25/28). For most psychometric property, studies of methodological qualities were found to be doubtful. Among measures evaluated in people with schizophrenia, Brief Assessment of Cognition in Schizophrenia, Cognitive Assessment Interview, MATRICS Consensus Cognitive Battery, and CogState Schizophrenia Battery were with the highest scores for clinical and research recommendation.CONCLUSIONS: Studies included in our review provide only limited quality evidence and future studies should consider adapting and validating measures using stronger designs and methods. Nonetheless, validated assessments of cognition could help in the management and allocating therapy in people with SMDs in LMICs.",

author = "Haile, {Yohannes Gebreegziabhere} and Kassahun Habatmu and Andualem Derese and Hetta Gouse and Lawrie, {Stephen M} and Matteo Cella and Atalay Alem",

note = "Funding Information: We would like to thank Dr Helen Jack for providing a 2-week systematic review training and shaping the scope as well as the search terms of this review. Our special thanks go to staffs of the department of psychiatry, Addis Ababa University, who provided valuable comments on different occasions. We would also like to thank Debre Berhan University for sponsoring the primary investigator to conduct this review. Finally, we would like to thank the African Mental Health Research Initiative (AMARI), because this work was supported by the DELTAS Africa Initiative [DEL-15-01] through the first author (YG). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS){\textquoteright}s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa{\textquoteright}s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [DEL-15-01] and the UK government. The views expressed in this publication are those of the author(s) and not necessarily those of AAS, NEPAD Agency, Wellcome Trust or the UK government. Funding Information: This work was supported by the DELTAS Africa Initiative [DEL-15-01] through the first author (YG). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS){\textquoteright}s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa{\textquoteright}s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [DEL-15-01] and the UK government. The views expressed in this publication are those of the author(s) and not necessarily those of AAS, NEPAD Agency, WellcomeTrust or the UK government. The funder has no role in the interpretation of findings and decision for publication. Publisher Copyright: {\textcopyright} 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = jun,

day = "18",

doi = "10.1007/s00127-021-02120-x",

language = "English",

journal = "Social Psychiatry and Psychiatric Epidemiology",

issn = "0933-7954",

publisher = "Science House",

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TY - JOUR

T1 - Assessing cognition in people with severe mental disorders in low- and middle-income countries

T2 - a systematic review of assessment measures

AU - Haile, Yohannes Gebreegziabhere

AU - Habatmu, Kassahun

AU - Derese, Andualem

AU - Gouse, Hetta

AU - Lawrie, Stephen M

AU - Cella, Matteo

AU - Alem, Atalay

N1 - Funding Information: We would like to thank Dr Helen Jack for providing a 2-week systematic review training and shaping the scope as well as the search terms of this review. Our special thanks go to staffs of the department of psychiatry, Addis Ababa University, who provided valuable comments on different occasions. We would also like to thank Debre Berhan University for sponsoring the primary investigator to conduct this review. Finally, we would like to thank the African Mental Health Research Initiative (AMARI), because this work was supported by the DELTAS Africa Initiative [DEL-15-01] through the first author (YG). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [DEL-15-01] and the UK government. The views expressed in this publication are those of the author(s) and not necessarily those of AAS, NEPAD Agency, Wellcome Trust or the UK government. Funding Information: This work was supported by the DELTAS Africa Initiative [DEL-15-01] through the first author (YG). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [DEL-15-01] and the UK government. The views expressed in this publication are those of the author(s) and not necessarily those of AAS, NEPAD Agency, WellcomeTrust or the UK government. The funder has no role in the interpretation of findings and decision for publication. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/6/18

Y1 - 2021/6/18

N2 - BACKGROUND: Cognitive difficulties are common in people with severe mental disorders (SMDs) and various measures of cognition are of proven validity. However, there is a lack of systematic evidence regarding the psychometric properties of these measures in low- and middle-income countries (LMICs).OBJECTIVE: To systematically review the psychometric properties of cognitive measures validated in people with SMDs in LMICs.METHODS: We conducted a systematic review of the literature by searching from four electronic databases. Two authors independently screened studies for their eligibility. Measurement properties of measures in all included studies were extracted. All eligible measures were assessed against criteria set for clinical and research recommendations. Results are summarized narratively and measures were grouped by measurement type and population.RESULTS: We identified 23 unique measures from 28 studies. None of these was from low-income settings. Seventeen of the measures were performance-based. The majority (n = 16/23) of the measures were validated in people with schizophrenia. The most commonly reported measurement properties were: known group, convergent, and divergent validity (n = 25/28). For most psychometric property, studies of methodological qualities were found to be doubtful. Among measures evaluated in people with schizophrenia, Brief Assessment of Cognition in Schizophrenia, Cognitive Assessment Interview, MATRICS Consensus Cognitive Battery, and CogState Schizophrenia Battery were with the highest scores for clinical and research recommendation.CONCLUSIONS: Studies included in our review provide only limited quality evidence and future studies should consider adapting and validating measures using stronger designs and methods. Nonetheless, validated assessments of cognition could help in the management and allocating therapy in people with SMDs in LMICs.

AB - BACKGROUND: Cognitive difficulties are common in people with severe mental disorders (SMDs) and various measures of cognition are of proven validity. However, there is a lack of systematic evidence regarding the psychometric properties of these measures in low- and middle-income countries (LMICs).OBJECTIVE: To systematically review the psychometric properties of cognitive measures validated in people with SMDs in LMICs.METHODS: We conducted a systematic review of the literature by searching from four electronic databases. Two authors independently screened studies for their eligibility. Measurement properties of measures in all included studies were extracted. All eligible measures were assessed against criteria set for clinical and research recommendations. Results are summarized narratively and measures were grouped by measurement type and population.RESULTS: We identified 23 unique measures from 28 studies. None of these was from low-income settings. Seventeen of the measures were performance-based. The majority (n = 16/23) of the measures were validated in people with schizophrenia. The most commonly reported measurement properties were: known group, convergent, and divergent validity (n = 25/28). For most psychometric property, studies of methodological qualities were found to be doubtful. Among measures evaluated in people with schizophrenia, Brief Assessment of Cognition in Schizophrenia, Cognitive Assessment Interview, MATRICS Consensus Cognitive Battery, and CogState Schizophrenia Battery were with the highest scores for clinical and research recommendation.CONCLUSIONS: Studies included in our review provide only limited quality evidence and future studies should consider adapting and validating measures using stronger designs and methods. Nonetheless, validated assessments of cognition could help in the management and allocating therapy in people with SMDs in LMICs.

UR - http://www.scopus.com/inward/record.url?scp=85108226600&partnerID=8YFLogxK

U2 - 10.1007/s00127-021-02120-x

DO - 10.1007/s00127-021-02120-x

M3 - Review article

C2 - 34145463

SN - 0933-7954

JO - Social Psychiatry and Psychiatric Epidemiology

JF - Social Psychiatry and Psychiatric Epidemiology

ER -

Assessing cognition in people with severe mental disorders in low- and middle-income countries: a systematic review of assessment measures

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