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. 2019 Apr 28;8(5):586.
doi: 10.3390/jcm8050586.

Cognitive Reserve Assessment Scale in Health (CRASH): Its Validity and Reliability

Affiliations

Cognitive Reserve Assessment Scale in Health (CRASH): Its Validity and Reliability

Silvia Amoretti et al. J Clin Med. .

Abstract

(1) Background: The cognitive reserve (CR) concept has not been precisely defined in severe mental disorders and has been estimated using heterogeneous methods. This study aims to investigate and develop the psychometric properties of the Cognitive Reserve Assessment Scale in Health (CRASH), an instrument designed to measure CR in people with severe mental illness; (2) Methods: 100 patients with severe mental illness (non-affective psychoses and affective disorders) and 66 healthy controls were included. The internal consistency and convergent validity of CRASH were assessed. Spearman's correlations coefficients were also performed to examine the relationship between CRASH and neuropsychological tests, psychosocial functioning, and clinical course; (3) Results: The internal consistency was high (Cronbach's alpha coefficient = 0.903). The CRASH global score had a large positive correlation with the Cognitive reserve questionnaire total score (r = 0.838, p < 0.001), demonstrating good convergent validity. The correlation coefficients between the CRASH total scores and clinical, functional, and neuropsychological performance were different between groups. In order to provide clinical interpretation, severity classification based on diagnosis (non-affective psychotic disorders, affective disorders, and healthy controls) have been created; (4) Conclusions: CRASH is the first CR measure developed specifically for patients with severe mental illness, facilitating reliable and valid measurement of this construct. The scale may aid in the stratification of patients and the implementation of personalized interventions.

Keywords: affective disorders; assessment; cognition; cognitive reserve; non-affective psychosis; psychosocial functioning; reliability; severe mental illness; validity.

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Conflict of interest statement

A.M.A. has received funding for research projects and/or honoraria as a consultant or speaker for the following companies and institutions: Otsuka, Pfizer, AstraZeneca, Bristol-Myers Siquibb, Lundbeck, Brain and Behaviour Foundation (NARSAD Independent Investigator), the Spanish Ministry of Economy and Competitiveness, and Instituto de Salud Carlos III. I.G. has received grants and served as consultant, advisor or CME speaker for the following identities: AstraZeneca, Ferrer, Janssen Cilag, and Lundbeck, Lundbeck-Otsuka, Spanish Ministry of Economy and Competitiveness, and Instituto de Salud Carlos III. M.B. (Miquel Bioque) has received honoraria from talks and consultancy of Adamed, has received honoraria from consultancy of Ferrer, has received research support and honoraria from talks and consultancy of Janssen-Cilag, has received honoraria from talks and consultancy of Lundbeck, has received honoraria from talks and consultancy of Otsuka, and has received a research prize from Pfizer. C.G.R. has received honoraria/travel support from Janssen-Cilag, Lundbeck, and Ferrer. E.F.-E. has received unrestricted research funding from Genus Pharmaceuticals and consultancy fees from Roche/Genentech. E.V. has received research support from or served as a consultant, adviser, or speaker for AB-Biotics, Actavis, Allergan, Angelini, AstraZeneca, Bristol-Myers Squibb, Dainippon Sumitomo Pharma, Ferrer, Forest Research Institute, Gedeon Richter, Glaxo-Smith-Kline, Janssen, Lundbeck, Otsuka, Pfizer, Roche, Sanofi-Aventis, Servier, Shire, Sunovion, Takeda, Telefónica, the Brain and Behaviour Foundation, the Spanish Ministry of Science and Innovation (CIBERSAM), the Seventh European Framework Programme (ENBREC), and the Stanley Medical Research Institute. M.B. (Miquel Bernardo) has been a consultant for, received grant/research support and honoraria from, and been on the speakers/advisory board of ABBiotics, Adamed, AMGEN, Eli Lilly, Ferrer, Forum Pharmaceuticals, Gedeon, Janssen-Cilag, Lundbeck, Otsuka, Pfizer, and Roche. The rest of authors report no biomedical financial interests or potential conflicts of interest.

Figures

Figure 1
Figure 1
Curve between patients and controls (CRASH and cognitive reserve questionnaire CRQ). 1 ROC = receiver operating characteristic, 2 CRASH = Cognitive Reserve Assessment Scale in Health, 3 CRQ = Cognitive Reserve Questionnaire.

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