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. 2022 Mar 2;8(2):e55.
doi: 10.1192/bjo.2022.17.

Stability over time of scores on psychiatric rating scales, questionnaires and cognitive tests in healthy controls

Katharina Stahl  1 , Kristina Adorjan  2 , Heike Anderson-Schmidt  3 , Monika Budde  4 , Ashley L Comes  4 , Katrin Gade  3 , Maria Heilbronner  4 , Janos L Kalman  5 , Farahnaz Klöhn-Saghatolislam  4 , Mojtaba Oraki Kohshour  6 , Sergi Papiol  2 , Daniela Reich-Erkelenz  4 , Sabrina K Schaupp  4 , Eva C Schulte  2 , Fanny Senner  2 , Thomas Vogl  4 , Jens Wiltfang  7 , Eva Reininghaus  8 , Peter Falkai  9 , Thomas G Schulze  10 , Heike Bickeböller  1 , Urs Heilbronner  4
Affiliations

Stability over time of scores on psychiatric rating scales, questionnaires and cognitive tests in healthy controls

Katharina Stahl et al. BJPsych Open. .

Abstract

Background: Case-only longitudinal studies are common in psychiatry. Further, it is assumed that psychiatric ratings and questionnaire results of healthy controls stay stable over foreseeable time ranges. For cognitive tests, improvements over time are expected, but data for more than two administrations are scarce.

Aims: We comprehensively investigated the longitudinal course for trends over time in cognitive and symptom measurements for severe mental disorders. Assessments included the Trail Making Tests, verbal Digit Span tests, Global Assessment of Functioning, Inventory of Depressive Symptomatology, the Positive and Negative Syndrome Scale, and the Young Mania Rating Scale, among others.

Method: Using the data of control individuals (n = 326) from the PsyCourse study who had up to four assessments over 18 months, we modelled the course using linear mixed models or logistic regression. The slopes or odds ratios were estimated and adjusted for age and gender. We also assessed the robustness of these results using a longitudinal non-parametric test in a sensitivity analysis.

Results: Small effects were detected for most cognitive tests, indicating a performance improvement over time (P < 0.05). However, for most of the symptom rating scales and questionnaires, no effects were detected, in line with our initial hypothesis.

Conclusions: The slightly but consistently improved performance in the cognitive tests speaks of a test-unspecific positive trend, while psychiatric ratings and questionnaire results remain stable over the observed period. These detectable improvements need to be considered when interpreting longitudinal courses. We therefore recommend recruiting control participants if cognitive tests are administered.

Keywords: Neuropsychology; bipolar affective disorders; depressive disorders; longitudinal course; schizophrenia.

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Conflict of interest statement

T.S. is a member of the BJPsych Open editorial board and did not take part in the review or decision-making process of this paper.

Figures

Fig. 1
Fig. 1
Courses of the Trail Making Test Part B (TMT_B) and Inventory of Depressive Symptomatology scale (IDS) with means and standard deviations of cognitive tests over time. The vertical black bars depict one unit of the standard deviation in each direction. TMT_B serves as an example of cognitive tests, IDS of rating scales. To illustrate differences in variability, we plotted both TMT_B and IDS on the same scale.
Fig. 2
Fig. 2
Means and standard deviations of cognitive tests over time. The vertical bar depicts one unit of the standard deviation in each direction. TMT, Trail Making Test, Parts A and B; DG_SYM, Digit Symbol Test; DGT_SP, verbal Digit Span test; frw, forwards; bck, backwards; VLMT, German version of the Rey Auditory Verbal Learning Test; lss_d, loss of correct words after distraction; lss_t, loss of correct words after time span; rec, recognition of words.
See this image and copyright information in PMC

References

    1. James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the global burden of disease Study 2017. Lancet 2018; 392: 1789–858. - PMC - PubMed
    1. Hjorthøj C, Stürup AE, McGrath JJ, Nordentoft M. Years of potential life lost and life expectancy in schizophrenia: a systematic review and meta-analysis. Lancet Psychiatry 2017; 4: 295–301. - PubMed
    1. Heilbronner U, Samara M, Leucht S, Falkai P, Schulze TG. The longitudinal course of schizophrenia across the lifespan: clinical, cognitive, and neurobiological aspects. Harv Rev Psychiatry 2016; 24: 118–28. - PMC - PubMed
    1. Scharfen J, Peters JM, Holling H. Retest effects in cognitive ability tests: a meta-analysis. Intelligence 2018; 67: 44–66.
    1. Snoddy GS. Learning and stability: a psychophysiological analysis of a case of motor learning with clinical applications. J Appl Psychol 1926; 10: 1–36.