Background: Discrepancies between patient- and clinician-perceived cognitive functioning in people with schizophrenia have been associated with functional impairment, which can be further confounded by side effects of treatment. Perceived cognitive impairment and level of agreement between patient, clinician, and caregiver responses on the New York Assessment of Adverse Cognitive Effects of Neuropsychiatric Treatment (NY-AACENT) were assessed for patients with schizophrenia switching to the long-acting injectable antipsychotic aripiprazole lauroxil (AL).

Methods: Clinically stable adults with schizophrenia with inadequate response or intolerability to paliperidone palmitate or risperidone LAI were switched to 6-month, open-label treatment with AL (441, 662, or 882 mg monthly or 882 mg q6wk). NY-AACENT patient, caregiver, and clinician forms were completed at baseline and month 6 or early termination. Level of agreement between groups in ratings of cognitive difficulty (not present, mild, moderate, severe, extreme) in NY-AACENT domains (Working Memory, Attention/Vigilance, Verbal Learning/Memory, Visual Learning/Memory, Reasoning and Problem Solving, Speed of Processing, Social Cognition) was evaluated at baseline and last assessment using weighted kappa coefficients.

Results: Fifty-one patients (mean age, 40.6 years) were enrolled; 35 completed the study. At baseline (n=50), cognitive difficulties were most commonly rated ‘not present’ or ‘mild’ in all NY-AACENT domains by patients (58%–86% across domains), clinicians (62%–94%), and caregivers (50%–92%). Percentages reporting cognitive difficulties ‘not present’ or ‘mild’ increased at last assessment for all reporters. Weighted kappa coefficients indicated fair to substantial agreement between patients and clinicians across domains at last assessment (0.32–0.64; baseline: 0.14–0.55); patient-caregiver agreement ranged from 0.07 to 0.50 at last assessment.

Discussion: In this analysis, clinician, caregiver, and patient reports indicate reduced cognitive impairment, on average, in all NY-AACENT domains after 6 months of AL treatment. Patient-clinician agreement on magnitude of improvement was higher than patient–caregiver agreement and increased from baseline to last assessment.