Self-awareness of cognitive functioning in schizophrenia: Patients and their relatives

Cognitive impairment has been recognized since the earliest descriptions of
schizophrenia as a core feature of the illness and different programmes have been
developed to remediate these deficits. In all likelihood it is important for
compliance and adherence to treatment that not only the patients but also their
relatives be aware of the patients cognitive deficits. 62 patients with a
diagnosis of schizophrenia and, for each one of them, one family member and an
informant from the medical staff, were recruited and administered the
Schizophrenia Cognition Rating Scale. Patients were tested for cognitive deficits
with a neuropsychological battery and their performance was compared to the
ratings of patients cognitive functioning provided by the patient himself, his
family member and the informant. Results show no significant association between
cognitive performance and SCoRS ratings in patients; only for executive functions
the patient's performance was found to be predictive of the respective judgment
at SCoRS given by the relative. This is the first study to investigate awareness
of the patients cognitive deficits, both in the patients itself and in first
degree relatives, through a direct comparison between subjective clinical ratings
and objective measures of cognitive performances. Both patients and relatives are
unaware of the patients' cognitive deficits, this could affect adherence to
remediation treatment and need to be specifically addressed from future
rehabilitation strategies.