In the present study, the correspondence between clinician-assessed
and self-reported neurocognitive performance was contrasted with scores
obtained from psychometric neuropsychological tests in 148 psychiatric
in-patients. Results revealed that self-reported cognitive functioning
was strongly associated with depressive symptomatology but was only
poorly related to psychometric neurocognitive performance, particularly
in schizophrenia. After illness denial was controlled for, the
overall association between subjective and objective test performance
was slightly increased but still failed to reach significance in six
out of eight analyses. In approximately 20% to 40% of all cases,
clinicians judged memory performance to be normal despite substantial
impairment revealed by neuropsychological test results (attention
parameters: 7–51%). Since (ecological) validity and reliability
have been demonstrated for many neurocognitive paradigms, the present
results question the validity of non-psychometric neurocognitive
assessment and call for a complementation of clinical judgment with
neurocognitive assessment. Reasons for decreased sensitivity of
self-reported and clinician-assessed neurocognitive functioning are
discussed. (JINS, 2004, 10, 623–633.)