The relationship between subjective cognitive complaints and objective cognitive measures in the epilepsy clinic : an exploratory study of the Neuro-QOL Subjective Cognition Measures.

One of the most consistently distressing symptoms for patients with epilepsy and psychogenic non-epileptic events (PNEE) is cognitive dysfunction (Meneses, Pais-Ribeiro, da Silva & Giovagnoli, 2009). Deficits in cognitive domains such as memory, language and executive functioning contribute to a decreased quality of life in both patients with epilepsy and those with PNEE (Meneses et al., 2009). There is evidence of an association of cognitive complaints in patients with epilepsy and PNEE, but the relationship between subjective cognitive complaints and objective cognitive deficits is currently unclear (Giovagnoli, 2013). The current study explored the relationship between subjective cognitive complaints and objective cognitive measures through analysis of retrospective data collected at an epilepsy clinic. Data from thirty-nine patients diagnosed with either epilepsy, PNEE or PNEE with comorbid epilepsy were reviewed. Results did not reveal any significant relationships between subjective cognitive complaints and objective cognitive impairment in any of the cognitive domains assessed (memory, visual skills, language, attention/working memory, executive functioning, and processing speed). Additionally, subjective measures of cognition demonstrated high sensitivity but low specificity for objective cognitive deficits across the different domains of cognition. Depression emerged as a significant predictor of subjective cognitive complaints over and above other predictors such as anxiety and objective measures of cognition. A secondary, exploratory analysis found no significant difference between diagnostic groups in terms of the relationships between subjective cognitive complains and objective cognitive deficits. The results suggest that subjective cognitive complaints should be interpreted cautiously as measures of cognition in this population.