Cognitive Complaints in Schizophrenia: A Meta-Analysis of Studies Using the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS): Les plaintes cognitives dans la schizophrénie : Une méta-analyse des études utilisant la Subjective Scale To Investigate Cognition in Schizophrenia (SSTICS).

Background: Subjective cognitive complaints, or neurocognitive insight, reflect to patients' awareness of cognitive functioning. In schizophrenia, these complaints show inconsistent links with objective cognition, psychiatric symptoms, and illness insight. The Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS), a validated self-report tool developed in Canada and used internationally, enables a homogeneous synthesis. Objective: This meta-analysis examined whether subjective complaints measured with the SSTICS are associated with objective cognition, psychiatric symptoms, and illness insight, and reviewed its factorial structure. Method: We conducted a meta-analysis following PRISMA guidelines. Systematic searches of PubMed, Web of Science, and Google Scholar identified studies using the SSTICS in psychiatric populations. Eligible studies compared patients to healthy controls and/or examined correlations with cognition, symptoms, or illness insight or conducted factor analyses of the SSTICS domains. Results: Twenty-five studies (N = 3,205) met criteria. Schizophrenia patients reported more cognitive complaints than controls (d = 0.746). No significant correlation emerged with global objective cognition (r = 0.105). Complaints were unrelated to positive, negative, or general symptoms but showed a moderate association with depressive symptoms (r = 0.300) and a small one with illness insight (r = 0.155). Factor analyses consistently identified 3 domains: memory, attention, and daily living. Conclusions: SSTICS-based complaints are substantial in schizophrenia but largely dissociated from objective cognition, reflecting impaired neurocognitive insight. Instead, they are more strongly linked to depressive symptoms, suggesting complaints reflect emotional distress rather than actual deficits. Findings support refining SSTICS subscales and extending investigations to other psychiatric populations.