Inter-rater reliability and psychometric characteristics of the Italian version of the Cognitive Assessment Interview (CAI)

Objectives Cognitive impairment in people with schizophrenia is a core feature of the disorder. It is increasingly regarded as an important target of both pharmacological and rehabilitation treatments. The Cognitive Assessment Interview (CAI), developed as part of the "Measurement and Treatment Research to Improve Cognition in Schizophrenia" (MATRICS) initiative, is an interview-based measures of cognition. In this paper, we report on the inter-rater reliability and psychometric properties of the CAI Italian translation. Methods One psychiatrist, one psychologist and one trainee in psychiatry translated the CAI from English to Italian. The author of the original version, Josef Ventura (JV), evaluated the resulting Italian version to ensure the absence of translation or interpretation errors. The three translators examined the modifications suggested by JV and applied them when deemed appropriate or re-discussed the suggestions with him, until they reached an agreement. JV trained the three translators and two additional persons (one psychiatrist and one trainee in psychiatry) in the use of the interview. When they reached a satisfactory degree of experience with the instrument became trainers of other raters. The intraclass correlation coefficients (ICCs) and the Cronbach's alpha coefficients provided, respectively, a measure of the reliability and internal consistency of the Italian version of the CAI. Results For the three considered scores (patient, informant and composite scores) of each item of the CAI, as well as for the score on Global Assessment of Functioning-Cognition in Schizophrenia, the ICCs ranged from 0.69 to 0.91. Cronbach's alpha coefficients for the CAI patient, informant e composite scores were respectively 0.90, 0.93 and 0.93. Conclusions The Italian version of the CAI revealed good to excellent reliability and excellent internal consistency. The availability of such a suitable tool may help clinicians to assess cognitive impairment and its impact on daily functioning in patients with schizophrenia.