Contributors: Fondation FondaMental Créteil; Centre Hospitalier de Versailles André Mignot (CHV); Centre de recherche en épidémiologie et santé des populations (CESP); Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay; Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier); Hôpital de la Colombière; Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS); Aix Marseille Université (AMU); Hôpital de la Timone CHU - APHM (TIMONE); Institut de Génomique Fonctionnelle (IGF); Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM); Centre Hospitalier Universitaire Strasbourg (CHU Strasbourg); Les Hôpitaux Universitaires de Strasbourg (HUS); Sociétés, acteurs, gouvernement en Europe (SAGE); École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE); Centre Hospitalier le Vinatier Bron; Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL); Université Claude Bernard Lyon 1 (UCBL); Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Hôpital Louis Mourier - AP-HP Colombes; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité); Université Sorbonne Paris Cité (USPC); GIN Grenoble Institut des Neurosciences (GIN); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA); Centre Hospitalier Universitaire CHU Grenoble (CHUGA); CHU Clermont-Ferrand; Université Clermont Auvergne (UCA); Centre hospitalier Charles Perrens Bordeaux; Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA); Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS); Hôpital Henri Mondor; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12); Institut Mondor de Recherche Biomédicale (IMRB); Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12); FACE-SZ (FondaMental Academic Centers of Expertise—Schizophrenia) Group: B Aouizerate, V Barteau, S Bensalem, F Berna, O Blanc, E Bourguignon, L Boyer, D CapdevielleI Chéreau, G Chesnoy-Servanin, T D'Amato, A Deloge, H Denizot, J M Dorey, C Dubertret, J Dubreucq, S Esselin, C Faget, C Fluttaz, G Fond, F Gabayet, O Godin, E Haffen, R M Honciuc, M Jarroir, D Lacelle, C Lançon, H Laouamri, M Leboyer, P M Llorca, J Mallet, E Metairie, D Misdrahi, C Passerieux, J Petrucci, P Peri, B Pignon, S Pires, C Portalier, R Rey, C Roman, F Schürhoff, K Souryis, A Szöke, M Urbach, F Vaillant, A, Vehier, P Vidailhet, E Vilà, G Wahiche, H Yazbek, A Zinetti-Bertschy; ANR-11-IDEX-0004,SUPER,Sorbonne Universités à Paris pour l'Enseignement et la Recherche(2011); ANR-10-COHO-0010,Psy-COH,FondaMental-Cohortes(2010)
نبذة مختصرة : International audience ; Aim: The anticholinergic properties of medications are associated with poorer cognitive performance in schizophrenia. Numerous scales have been developed to assess anticholinergic burden and yet, there is no consensus indicating which anticholinergic burden scale is more relevant for patients with schizophrenia. We aimed to identify valid scales for estimating the risk of iatrogenic cognitive impairment in schizophrenia.Methods: We identified 27 scales in a literature review. The responses to neuropsychological tests of 839 individuals with schizophrenia or schizoaffective disorder in the FACE-SZ database were collected between 2010 and 2021. We estimated the association between objective global cognitive performance and the 27 scales, the number of psychotropic drugs, and chlorpromazine and lorazepam equivalents in bivariable regressions in a cross-sectional design. We then adjusted the bivariable models with covariates: the predictors significantly associated with cognitive performance in multiple linear regressions were considered to have good concurrent validity to assess cognitive performance.Results: Eight scales, the number of psychotropic drugs, and drug equivalents were significantly associated with cognitive impairment. The number of psychotropic drugs, the most convenient predictor to compute, was associated with worse executive function (Standardized β = -0.12, p = .004) and reasoning (Standardized β = -0.08, p = .037).Conclusion: Anticholinergic burden, the number of psychotropic drugs, and drug equivalents were weakly associated with cognition, thus suggesting that cognitive impairment in schizophrenia and schizoaffective disorder is explained by factors other than medication. The number of psychotropic drugs was the most parsimonious method to assess the risk of iatrogenic cognitive impairment.
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