The British Columbia Cognitive Complaints Inventory (BC-CCI)

• The British Columbia Cognitive Complaints Inventory (BC-CCI) is a rapid screening tool that assesses perceived cognitive difficulties specifically in patients with Major Depressive Disorder (MDD) and related mood disorders.

• The scale consists of 6 items assessing perceived problems with concentration, memory, expressing thoughts, word finding, slow thinking, and difficulty solving problems in the past 7 days.  It is self-rated by patients and takes less than 5 minutes to complete.  Scores on each item (ranging from 0, not at all, to 3, very much) are summed to yield a total score ranging from 0 to 18; higher scores indicate greater severity of cognitive complaints.

• Categorical scoring for the BC-CCI:

• The BC-CCI expanded version also includes 3 items to assess the functional and quality of life impacts of cognitive complaints.

• The BC-CCI was validated in a sample of 62 inpatients and outpatients meeting DSM-IV criteria for MDD and 112 healthy controls (Iverson & Lam, 2013), demonstrating good reliability and discriminant validity.

• How can the BC-CCI be used to guide clinical management of patients with depression? The BC-CCI is not a diagnostic tool and should therefore be used in conjunction with a symptom rating scale such as the PHQ-9 or the QIDS-SR. However, the BC-CCI total score can provide a quick measure of perceived cognitive difficulties that can be used to monitor changes in these symptoms over time. Using a validated tool such as the BC-CCI can also save time during clinical assessment and ensure these symptoms are assessed in a standardized way.

• Although perceived cognitive difficulties should lessen with successful treatment of depression, some evidence suggests that individuals with MDD continue to experience cognitive difficulties despite the remission of other depressive symptoms.  In these cases, it may be especially important to monitor perceived cognitive difficulties over time.

Download the BC-CCI

• The BC-CCI is freely available for individual clinical use.  For other uses, including research, please contact Dr. Grant Iverson, giverson@mgh.harvard.edu

• Download here: BC-CCI scale

BC-CCI Citations:

• Iverson GL & Lam RW. Rapid screening for perceived cognitive impairment in major depressive disorder.
  Ann Clin Psychiatry 2013; 25:135.
  This is the original validation paper for the BC-CCI.

• Anees M, Pervaiz MS, Aziz S, Elahi I. Predictors of cognitive impairment and its association with mortality in maintenance hemodialysis patients: A prospective follow-up study.
  Pak J Med Sci. 2024 May-Jun;40(5):933-938.

• Stevens J, Schneider LD, Husain AM, Ito D, Fuller DS, Zee PC, Macfadden W. Impairment in Functioning and Quality of Life in Patients with Idiopathic Hypersomnia: The Real World Idiopathic Hypersomnia Outcomes Study (ARISE).
  Nat Sci Sleep. 2023 Aug 2;15:593-606.

• Bae CJ, Zee PC, Leary EB, Fuller DS, Macfadden W, Candler S, Steininger TL, Husain AM. Effectiveness and tolerability in people with narcolepsy transitioning from sodium oxybate to low-sodium oxybate: Data from the real-world TENOR study.
  Sleep Med. 2023 Sep;109:65-74. Erratum in: Sleep Med. 2024 Jul;119:17-18.

• Kyle SD, Hurry MED, Emsley R, et al. The effects of digital cognitive behavioral therapy for insomnia on cognitive function: a randomized controlled trial.
  Sleep. 2020; 43(9):zsaa034.

• Alonso-Prieto E, Rubino C, Lucey M, Evans VC, Tam EM, Woo C, Iverson GI, Chakrabarty T, Yatham LN, Lam RW. Self-reported cognitive complaints in patients with major depressive disorder treated with desvenlafaxine: Relationships to work functioning.
  Psychiatry Research 2019; 272:144-148.

• Zubair UB, Butt B. Association of quality of sleep with cognitive decline among the patients of chronic didney disease undergoing haemodialysis.
  J Ayub Med Coll Abbottabad 2017; 29:619-622.

• Lange RT, Iverson GL, Brooks BL, Rennison VL. Influence of poor effort on self-reported symptoms and neurocognitive test performance following mild traumatic brain injury.
  J Clin Exp Neuropsychol 2010; 32:961-72.

• Iverson GL, Le Page J, Koehler BE, Shojania K, Badii M. Test of Memory Malingering (TOMM) scores are not affected by chronic pain or depression in patients with fibromyalgia.
  Clin Neuropsychol. 2007; 21(3):532-46.