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. 2020 Sep:223:297-304.
doi: 10.1016/j.schres.2020.08.010. Epub 2020 Sep 11.

Factor structure of cognitive performance and functional capacity in schizophrenia: Evidence for differences across functional capacity measures

Philip D Harvey  1 , William P Horan  2 , Alexandra S Atkins  3 , Heather Stevens  3 , Matthew Welch  3 , Joshua Yuan  3 , Thomas L Patterson  4 , Meera Narasimhan  5 , Richard S E Keefe  6
Affiliations

Factor structure of cognitive performance and functional capacity in schizophrenia: Evidence for differences across functional capacity measures

Philip D Harvey et al. Schizophr Res. 2020 Sep.

Abstract

Background: Cognition and functional capacity predict functional outcomes in mental illness. Traditional approaches conceptualize cognition as comprised of domains, but many studies support a unifactorial structure. Some functional capacity measures may share a single-factor structure with cognition. In this study, we examined the factor structure of two measures of functional capacity, a conventional assessment and a newer computerized assessment, testing for a shared factor structure with cognition.

Methods: Patients with schizophrenia and healthy controls were examined with the MATRICS Consensus Cognitive Battery (MCCB), the UCSD Performance Based Skills Assessment (UPSA), and the Virtual Reality Functional Capacity Assessment Tool (VRFCAT). Models of the factor structures of the MCCB, UPSA, and VRFCAT were calculated, as were correlations between MCCB scores and individual VRFCAT objectives.

Results: The MCCB, VRFCAT, and UPSA all had unifactorial structures. The best fitting model of the correlations between MCCB and UPSA was a shared single factor, while the best fit for the relationship between MCCB and VRFCAT had two factors. Correlations between the MCCB domain and composite scores and the VRFCAT objectives suggested global rather than specific patterns of correlation.

Discussion: The relationship between cognitive performance and functional capacity was found to vary across functional capacity assessments. The UPSA and MCCB were not differentiated into separate factors, suggesting that the UPSA may overlap with neurocognitive performance. However, the VRFCAT appears to measure functional abilities that are separable from, yet correlated with, neurocognitive performance. It may provide a more distinctive assessment of the functional capacity construct.

Keywords: Functional capacity; Neurocognition; Schizophrenia.

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Conflict of interest statement

Declaration of competing interest William Horan, Alexandra Atkins, Heather Stevens, Matthew Welch, Joshua Yuan are full-time employees of VeraSci, Inc. In the last year, Dr. Harvey has received investigator-initiated research funding support from the Department of Veterans Affairs, the National Institute of Aging, the U.S. Department of Veterans Affairs, and the National Institute of Mental Health. He has received consulting fees or travel reimbursements from Alkermes, BioExcel, 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. Keefe is the owner of VeraSci, a company that has been paid to provide various services over the past 3 years for over 100 entities, most of which are pharmaceutical companies. VeraSci is the copyright holder of the VRFCAT and the Brief Assessment of Cognition (BAC). He has served as a consultant or Ad Board member for Merck, Akili, Avanir, GE Health, GW Pharma, Karuna, SK Life Sciences, Boehringer-Ingelheim, Jazz Pharma, Acadia, Biogen.

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