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SO473

Cognitive impairment in generalized anxiety disorder: prevalence, associated factors, and use of a brief screening scale

COGNITIVE IMPAIRMENT IN GENERALIZED ANXIETY DISORDER: PREVALENCE, CORRELATES, AND USE OF A BRIEF SCREENING QUESTIONNAIRE

Objective cognitive impairment was identified in approximately one-third of patients with generalized anxiety disorder, with attention and processing speed being the most frequently affected domain, while the brief screening scale showed limited discriminative ability.

The aim was to determine the prevalence and domain-specific pattern of objective cognitive impairment in individuals with generalized anxiety disorder (GAD), identify associated demographic and anxiety-related factors, and evaluate the use of the Taiwan Cognition Questionnaire (TCQ) as a screening tool in routine psychiatric assessment. This cross-sectional study included 200 Taiwanese outpatients diagnosed with GAD according to ICD-10 criteria at a university hospital; the GAD-7 and TCQ were administered as subjective measures, while the WMS-III Word Lists, Benton Visual Retention Test (BVRT), Wisconsin Card Sorting Test–64 Card Version (WCST-64), and Comprehensive Trail Making Test (CTMT) Trial 1 were administered as objective measures; domain-specific impairment was defined as performance below the 5th percentile, and overall impairment as impairment in two or more domains. Hierarchical regression, latent class analysis and regression, structural equation modeling (SEM), and ROC analysis were performed. Impairment rates were 10.0% for verbal learning and memory, 30.5% for nonverbal memory, 27.0% for executive functioning, and 40.0% for attention and processing speed, with an overall objective cognitive impairment rate of 31.0%. Latent class analysis identified a preserved cognitive profile in 76.5% (n=157) and a low cognitive performance profile in 23.5% (n=43); latent class regression yielded an odds ratio (OR) for education of 0.60 (95% CI 0.40–0.89, p=0.011). In the SEM, the effect of education on objective cognition was beta=0.598 (p<0.001), the effect of the GAD-7 score was beta=-0.206 (p=0.005), and the explained variance was R2=0.341; model fit was reported as X2(14)=35.15, p=0.001; CFI=0.907; TLI=0.813; RMSEA=0.087; SRMR=0.069. ROC analysis for the TCQ yielded an area under the curve (AUC) of 0.61 (95% CI 0.52–0.7, p=0.020), with an optimal cutoff of 6/7 (sensitivity 0.468, specificity 0.717), indicating limited discriminative ability. In conclusion, cognitive impairment in GAD is common and heterogeneous, lower educational attainment is the most consistently associated factor, overlap between subjective complaints and objective cognition is limited, and brief scales may support screening or triage but cannot replace objective testing. Limitations included the cross-sectional, single-center design, the absence of a comparison group, and the limited assessment of medication, sleep, and comorbidities.

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