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Evaluations des fonctions cognitives chez les patients schizophrènes au Liban

Abstract : Cognitive deficits is a fundamental characteristic of schizophrenia where the most affected function are particularly memory, attention, motor skills, executive functions and social cognition. Cognitive assessment is one of the best indicators of the functional and social prognosis of individuals. This assessment becomes a fundamental part in clinical practice and in research using batteries that differ widely in their content. In addition, subjective assessment of cognitive functions can give a more complete view of an individual's cognitive profile, but it cannot replace objective assessment measures, as patients' self-assessment of their neurocognitive functioning may not be entirely correct. Subjective cognitive complaints is recognized as indicators of potential cognitive dysfunction, with evidence suggesting that such complaints are a precursor to cognitive impairment. Thus, it is essential to understand and assess patients' awareness of their cognitive state.The thesis work presented here has several objectives. First, we deal with generalities concerning schizophrenia, impaired cognitive functions and their evaluations while also giving an overview of their evaluation in Lebanon. Secondly, in order to be able to assess cognitive functions in institutionalized schizophrenic patients, we worked at validating diagnostic and screening tools for cognitive disorders in schizophrenic subjects. Finally, we assess the subjective cognitive complaints in schizophrenic patients and the factors related to them. The results of this work led to the validation of the cognitive battery, BACS, in schizophrenic patients. The Arabic BACS is a reliable and useful tool for measuring cognitive performance in hospitalized patients with schizophrenia. In addition, the satisfactory psychometric qualities of MoCA make it a rapid screening tool for the cognitive functions of these patients. In addition, our results showed that patients with objective cognitive impairment could be aware of their cognitive impairment despite low disease awareness (insight). The most contributing factors of the subjective cognitive complaint were the general psychopathology subscale of the PANSS, the autonomy scale of the daily living scale (ADL) while those predictive of social cognitive complaint were the Depression Scale (Calgary).All of our work has demonstrated adequate psychometric properties of a neurocognitive battery, BACS and a screening tool, MOCA in Arabic, respectively in the diagnosis and screening of cognitive deficits in schizophrenic patients. Our studies could help clinicians apply these valid instruments in their daily clinical practice and include cognitive rehabilitation strategies in the treatment plan for patients with schizophrenia; which is currently lacking in the countries of the Middle East. Finally, our studies have shown that schizophrenic patients complain about their cognition. Further prospective studies are needed to better understand cognitive impairment in schizophrenic patients in order to help remedy it and thus allow better day-to-day functioning and life outside psychiatric institutions.
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Submitted on : Tuesday, February 8, 2022 - 12:20:14 PM
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Chadia El Haddad. Evaluations des fonctions cognitives chez les patients schizophrènes au Liban. Médecine humaine et pathologie. Université de Limoges, 2021. Français. ⟨NNT : 2021LIMO0082⟩. ⟨tel-03561582⟩

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