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Smaller than expected cognitive deficits in schizophrenia patients from the population-representative ABC catchment cohort

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Abstract

Most neuropsychological studies on schizophrenia suffer from sample selection bias, with male and chronic patients being overrepresented. This probably leads to an overestimation of cognitive impairments. The present study aimed to provide a less biased estimate of cognitive functions in schizophrenia using a population-representative catchment area sample. Schizophrenia patients (N = 89) from the prospective Mannheim ABC cohort were assessed 14 years after disease onset and first diagnosis, using a comprehensive neuropsychological test battery. A healthy control group (N = 90) was carefully matched according to age, gender, and geographic region (city, rural surrounds). The present sample was representative for the initial ABC cohort. In the comprehensive neuropsychological assessment, the schizophrenia patients were only moderately impaired as compared to the healthy control group (d = 0.56 for a general cognitive index, d = 0.42 for verbal memory, d = 0.61 for executive functions, d = 0.69 for attention). Only 33 % of the schizophrenia patients scored one standard deviation unit below the healthy control group in the general cognitive index. Neuropsychological performance did not correlate with measures of the clinical course including age at onset, number of hospital admissions, and time in paid work. Thus, in this population-representative sample of schizophrenia patients, neuropsychological deficits were less pronounced than expected from meta-analyses. In agreement with other epidemiological studies, this suggests a less devastating picture of cognition in schizophrenia.

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Acknowledgments

This study was funded by the German Society of Research DFG (DFG Wa 731/4 and HE 1697/4). The authors thank all patients and clinicians involved in the study.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University of Bonn, 53105, Bonn, Germany

    Leonhard Lennertz, Svenja Schulze-Rauschenbach, Wolfgang Maier & Michael Wagner

  2. Central Institute of Mental Health, Mannheim, Germany

    Wolfram an der Heiden, Regina Kronacher & Heinz Häfner

  3. German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany

    Michael Wagner

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  1. Leonhard Lennertz
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  2. Wolfram an der Heiden
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  3. Regina Kronacher
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  6. Heinz Häfner
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Correspondence to Leonhard Lennertz.

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Conflict of interest

Wolfgang Maier is consultant to E. Lilly and Lundbeck and received funds from E. Lilly, Otsuka, and Lundbeck. All other authors report no conflicts of interest.

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Lennertz, L., an der Heiden, W., Kronacher, R. et al. Smaller than expected cognitive deficits in schizophrenia patients from the population-representative ABC catchment cohort. Eur Arch Psychiatry Clin Neurosci 266, 423–431 (2016). https://doi.org/10.1007/s00406-015-0625-x

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  • DOI: https://doi.org/10.1007/s00406-015-0625-x

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