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For more than 20 years, euthanasia in Belgium and The Netherlands is allowed for unbearable suffering caused by terminal or non-terminal illnesses, including psychiatric disorders. Although euthanasia numbers have been increasing over the years, the percentage of cases involving people with a primary psychiatric diagnosis has remained stable (between 1 and 2%). For these cases, the Belgian and Dutch Euthanasia Laws operate similar due care criteria: a well-considered, repeated, and voluntary request from a legally competent adult; a medical condition without prospect of improvement; constant and unbearable suffering that cannot be alleviated; consultation of two independent physicians, including a psychiatrist; and a posteriori evaluation and control [1-3].

Objective: Cognitive problems and biases play an important role in the development and continuation of psychosis. A self-report measure of these deficits and processes was developed (Davos Assessment of Cognitive Biases Scale: DACOBS) and is evaluated in this study., Methods: An item pool made by international experts was used to develop a self-report scale on a sample of 138 schizophrenia spectrum patients. Another sample of 71 patients was recruited to validate the subscales. A group of 186 normal control subjects was recruited to establish norms and examine discriminative validity., Results: Factor analyses resulted in seven factors, each with six items (jumping to conclusions, belief inflexibility bias, attention for threat bias, external attribution bias, social cognition problems, subjective cognitive problems and safety behavior). All factors independently explained the variance (eigenvalues>2) and total explained variance was 45%. Reliability was good (Cronbach's alpha=.90; split-half reliability=.92; test-retest reliability=.86). The DACOBS discriminates between schizophrenia spectrum patients and normal control subjects. Validity was affirmed for five of seven subscales. The scale 'Subjective Cognitive problems' was not associated with objective cognitive functioning and 'Social cognition problems' was not associated with the Hinting task, but with the scale measuring ideas of social reference., Conclusions: The DACOBS scale, with seven independent subscales, is reliable and valid for use in clinical practice and research., (Copyright © 2012 Elsevier B.V. All rights reserved.)