Assessment of the German Version of Brief Assessment of Cognition in Schizophrenia (BACS)

Background: Cognitive impairments are a hallmark of schizophrenia-spectrum disorders (SSD), contributing to poor treatment outcomes and a key treatment target. The Brief Assessment of Cognition in Schizophrenia (BACS) battery is a validated tool designed to evaluate affected core domains in SSD. The...

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Main Authors: Matin Mortazavi, Jakob Amon, Iris Jäger, Genc Hasanaj, Zahra Aminifarsani, Kristin Fischer, Matthias Gamer, Alkomiet Hasan, Richard S.E. Keefe, Gabriele Sachs, Peter Falkai, Daniel Keeser, Florian Raabe, Elias Wagner
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Schizophrenia Research: Cognition
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Online Access:http://www.sciencedirect.com/science/article/pii/S2215001325000228
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Summary:Background: Cognitive impairments are a hallmark of schizophrenia-spectrum disorders (SSD), contributing to poor treatment outcomes and a key treatment target. The Brief Assessment of Cognition in Schizophrenia (BACS) battery is a validated tool designed to evaluate affected core domains in SSD. The present study evaluated psychometric properties of the German version of the BACS in a representative sample of individuals with SSD and healthy control subjects. Methods: N = 107 individuals with SSD and n = 175 healthy controls were assessed with the German version of the BACS. Diagnosis was confirmed with the Mini International Neuropsychiatric Interview according to DSM-V. Validity was assessed through pair-wise comparisons between SSD individuals and healthy controls and by using receiver operating characteristic analysis. Internal consistency as a measure of reliability was evaluated using McDonald's Omega and Cronbach's Alpha in addition to factor and principal component analysis. Results: All individuals with SSD exhibited significantly lower z-scores across all BACS subtests and BACS composite scores (Z < -1.5) compared to healthy controls. ROC analysis revealed good diagnostic accuracy with an AUC of 0.83 (95%CI: 0.78,0.88, sensitivity = 0.75, specificity = 0.75). Similar results were observed in sub-cohorts comprising clinically stable SSD patients and those with younger ages (18–35 years old). A unidimensional structure, supported by McDonald's Omega (ω = 0.72) and principal component analysis, confirmed robust internal reliability. Conclusions: The German BACS demonstrates strong validity and internal reliability when assessed in a representative case-control sample. This study provides an extensive normative dataset for individuals with SSD in German-speaking populations, facilitating future research and clinical assessments of cognition.
ISSN:2215-0013