Validation of the Questionnaire of Cognitive and Affective Empathy in patients with schizophrenia, major depressive disorder and bipolar disorder

Cogn Neuropsychiatry. 2020 Nov;25(6):466-479. doi: 10.1080/13546805.2020.1846025. Epub 2020 Nov 10.


Introduction: Alteration of empathy is common in patients with psychiatric disorders. Reliable and valid assessment tools for measuring empathy of clinical samples is needed. The Questionnaire of Cognitive and Affective Empathy (QCAE) is a newly-developed instrument to capture cognitive and affective components of empathy. This study aimed to validate the QCAE and compared self-reported empathy between clinical groups with varied psychiatric diagnoses and healthy sample.

Methods: The present study performed factor analysis for the QCAE on clinical samples in the Chinese setting (n = 534), including patients with schizophrenia (n = 158), bipolar disorder (n = 213) and major depressive disorder (n = 163). Internal consistency, internal correlation and convergent validity was examined in the subsample (n = 361). Group comparison among patients with schizophrenia, bipolar disorder, major depressive disorder and healthy controls (n = 107) was conducted to assess the discriminant validity.

Results: Our results indicated acceptable factor model, good reliability and validity of the QCAE. Impaired cognitive empathy was found in clinical samples, especially in patients with schizophrenia, while higher affective empathy was found in patients with bipolar disorder and major depressive disorder.

Conclusion: The QCAE is a useful tool in assessing empathy in patients with varied psychiatric diagnoses.

Keywords: QCAE; clinical sample; confirmatory factor analysis; reliability; validity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bipolar Disorder*
  • Cognition
  • Depressive Disorder, Major*
  • Empathy
  • Humans
  • Psychometrics / methods
  • Reproducibility of Results
  • Schizophrenia*
  • Surveys and Questionnaires