A SYSTEMATIC REVIEW OF BRIEF NEUROPSYCHOLOGICAL TESTS IN USE AMONG PATIENTS WITH PSYCHOTIC DISORDERS IN LOW AND MIDDLE INCOME COUNTRIES.

Introduction: Assessment of cognitive impairment is recommended as part of the comprehensive care of psychotic disorders. Brief neuropsychological assessments are particularly needed in low resource settings, but few reviews have focused on work done in this context. We aimed to undertake a systematic review of work done in low- and middle-income countries on brief neuropsychological assessments of cognitive impairment in psychotic disorders. Method: A systematic review was performed following PRISMA guidelines. We searched PubMed, Embase and PsycINFO for articles in which a brief neuropsychological test was used to assess cognitive impairment in patients with psychotic disorders in a low- and middle- income country (LMIC) context. Data on whether tests had been validated against the gold standard was abstracted. Data was also abstracted on the tests used, the domains assessed, personnel performing the tests, duration of tests and were abstracted. Results: A total of 29 articles met the inclusion criteria; these studied 3,184 participants with psychosis and 1,261 controls. No test was validated against a gold standard such as the MATRICS consensus cognitive battery. There was marked variability in the tests used, but most were delivered using pen and paper and assessed for cognitive impairment in the reasoning and problem solving domain. All but two publications used highly skilled personnel to perform the assessments.Conclusion: Although a few studies have focused on neuropsychological assessment of cognitive impairment in psychotic disorders in the LMIC context, none compared a brief neuropsychological test with a gold standard. Further work is therefore needed to determine the validity of brief neuropsychological assessment of cognitive impairment in psychotic disorders in these settings.