The MMSE shows a sensitivity for mild cognitive impairment of only 18% when a cut-off score of 26 out of a possible 30 is taken, whereas the MoCA displayed a sensitivity of 90% for mild cognitive impairment at a cut-off score of 26 out of a possible 30. 5, 14 A brief screening test for cognitive dysfunction would be the ideal for a busy clinical setting but no such instrument has been specifically validated for schizophrenia 15 However, because the cognitive deficits of schizophrenia tend to be global, 3 whilst perhaps targeting specific domains more than others, 4 the cognitive deficits do not differ much (if at all) from the cognitive domains tested by the Mini-Mental State Examination (MMSE) 16 and the Montreal Cognitive Assessment Test (MoCA) 17 even though both were developed for detecting dementia and mild cognitive impairment prior to dementia. 5, 14 Unfortunately, this method is not readily available in most clinical settings and is consequently not routinely used. 13 Because cognitive deficits in schizophrenia are of such clinical importance, it would be useful to detect them in a clinical setting.įor the detection of cognitive deficits in schizophrenia the ‘gold standard’ is a comprehensive neuropsychological test battery performed by a trained professional. 9, 10, 11 The importance of measuring cognitive deficits in schizophrenia is well recognised in that cognitive deficits have become a target for research in clinical trials 10, 12 and furthermore, in 2002, the National Institute of Mental Health established the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative to ascertain standards for evaluating outcomes in the treatment of schizophrenia. 4 Cognitive deficits in schizophrenia are significant, because they are common (in up to 75% of patients suffering from schizophrenia 5, 6) and are strongly associated with clinical 7, 8 and functional outcomes. 3 The American Psychiatric Association describes deficits in declarative memory, working memory, language function, executive functions, and slower processing speed. described substantial, generalised cognitive impairment in schizophrenia across multiple domains. IntroductionĬognitive impairment is a core feature of schizophrenia 1 that is less amenable to treatment than its two other core features: psychotic symptoms (especially) and negative symptoms. There was a statistically significant difference between participants’ performance on the MMSE and MoCA tests ( p = 0.000008).Ĭonclusion: Compared to the MMSE, the MoCA may be a more useful instrument to detect cognitive impairment in patients with schizophrenia. The mean MMSE score was 27.17 ± 2.64, and the mean MoCA score was 22.53 ± 3.91. Results: The sample consisted of 30 Afrikaans-speaking outpatients with schizophrenia. The MMSE and MoCA scores for each participant were matched and compared using the non-parametric Wilcoxon matched pairs test. Participants had at least seven years of formal education and had been in partial or full remission for at least 3 months. Method: The Afrikaans versions of the MMSE and MoCA were administered to Afrikaans-speaking adult outpatients. The objective of this study was to compare the results of the MMSE and MoCA in a group of outpatient schizophrenia sufferers to contribute to research into the instruments’ potential usefulness as screening tools for cognitive impairment in schizophrenia. Nevertheless, the Montreal Cognitive Assessment Test (MoCA) and the Mini-Mental State Examination (MMSE) show promise in this regard. Unfortunately there are no validated, brief screening instruments for the detection of cognitive impairment in schizophrenia. In most clinical settings comprehensive neuropsychological testing to detect cognitive impairment in schizophrenia patients is not readily available, but because cognitive deficits in schizophrenia are clinically important it would be useful to detect or at least screen for them in a clinical setting. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution,Īnd reproduction in any medium, provided the original work is properly cited.īackground: Cognitive impairment is a core feature of schizophrenia that also has strong prognostic significance. Ī comparison between the Mini-Mental State Examination and the Montreal Cognitive Assessment Test in schizophrenia A comparison between the Mini-Mental State Examination and the Montreal Cognitive Assessment Test in schizophrenia.
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