Cognitive functioning in severe psychiatric disorders: a general population study
- 347 Downloads
In clinical samples, patients with severe psychiatric disorders are found to have cognitive impairments. Less is known whether this applies to samples derived from the general population. We aimed to study cognitive functioning in a population-based sample comprising individuals with schizophrenia, other non-affective psychoses, bipolar disorders, major depressive disorder, and controls derived from the same population. The current analysis was based on 148 persons with severe mental disorders and 66 control subjects, derived from the Psychoses in Finland study. All subjects were interviewed with SCID, and a neuropsychological test battery was administered. Subjects with schizophrenia had a generalized cognitive impairment (d = 0.43–1.07), while those with other non-affective psychoses were impaired in verbal memory and processing speed (d = 0.43–0.59). Subjects with bipolar disorders were not impaired. Unipolar major depressive disorder associated with slowed processing speed (d = 0.64). Our findings on cognitive impairments in subjects with schizophrenia and other non-affective psychoses derived from the general population support previous findings of a generalized cognitive dysfunction in these subjects. However, our results suggest that subjects with bipolar disorders from non-clinical populations may not have significant cognitive impairments. Our results emphasize the importance of using control samples derived from the same population and studied similarly as those with disorders in evaluating cognitive functioning of subjects with severe mental disorders.
KeywordsNeuropsychology Schizophrenia Bipolar disorder Psychosis Major depressive disorder General population
Funding support: The study was supported by grants from the Academy of Finland (ATH #117159 and #131332; JL #200894; JS #118415).
Conflicts of interest
The authors declare that they have no conflict of interest.
- 17.Zanelli J, Reichenberg A, Morgan K, Fearon P, Kravariti E, Dazzan P, Morgan G, Zanelli C, Demjaha A, Jones PB, Doody GA (2010) Specific and generalized neuropsychological deficits: a comparison of patients with various first-episode psychosis presentations. Am J Psychiatry 167:78–85PubMedCrossRefGoogle Scholar
- 21.Perälä J, Suvisaari J, Saarni SI, Kuoppasalmi K, Isometsä E, Pirkola S, Partonen T, Tuulio-Henriksson A, Hintikka J, Kieseppä T, Härkänen T, Koskinen S, Lönnqvist J (2007) Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry 64:19–28PubMedCrossRefGoogle Scholar
- 22.Aromaa A, Koskinen S (eds) (2004) Health and functional capacity in Finland. Baseline results of the health 2000 health examination survey. Publications of the National Public Health Institute, B12. Available in English at http://www.ktl.fi/terveys2000/index.uk.html. Accessed 2 November 2009
- 23.Wittchen HU, Pfister H (1997) Dia-X-interviews: manual fur screening-Verfahren und interview. Swets und Zeitlinger, FrankfurtGoogle Scholar
- 24.First MB, Spitzer RL, Gibbon M, Williams JBW (1997) Structured clinical interview for DSM-IV axis I disorders—clinician version (SCID-CV). American Psychiatric Press, Washington, DCGoogle Scholar
- 26.Andreasen N (1984) The scale for the assessment of positive symptoms (SAPS). The University of Iowa, Iowa CityGoogle Scholar
- 29.Wechsler D (1987) Wechsler memory scale—revised (WMS-R), manual. The psychological corporation. Harcourt Brace Jovanovich, Inc., San AntonioGoogle Scholar
- 30.Delis DC, Kramer JH, Kaplan E, Ober BA (1987) California verbal learning test. Manual. Research edition. Harcourt Brace & Company, San AntonioGoogle Scholar
- 31.Wechsler D (1981) Wechsler adult intelligence scale—revised (WAIS-R), manual. The psychological corporation. Harcourt Brace Jovanovich, Inc., San AntonioGoogle Scholar
- 32.Reitan RM, Wolfson D (1993) The Halstead-Reitan neuropsychological test battery: theory and clinical interpretation. Neuropsychology Press, TucsonGoogle Scholar
- 33.Lezak MD, Howieson DB, Loring DW (2004) Neuropsychological assessment. Oxford University Press, New YorkGoogle Scholar
- 35.Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Earlbaum Associates, HillsdaleGoogle Scholar
- 36.SPSS Inc (2007) SPSS 16.0 for Windows. ChicagoGoogle Scholar
- 41.Greenwood TA, Braff DL, Light GA, Cadenhead KS, Calkins ME, Dobie DJ, Freedman R, Green MF, Gur RE, Gur RC, Mintz J, Nuechterlein KH, Olincy A, Radant AD, Seidman LJ, Siever LJ, Silverman JM, Stone WS, Swerdlow NR, Tsuang DW, Tsuang MT, Turetsky BI, Schork NJ (2007) Initial heritability analyses of endophenotypic measures for schizophrenia: the consortium on the genetics of schizophrenia. Arch Gen Psychiatry 64:1242–1250PubMedCrossRefGoogle Scholar
- 47.Zabala A, Rapado M, Arango C, Robles O, de la Serna E, Gonzáles C, Rodríguez-Sánchez JM, Andrés P, Mayoral M, Bombín I (2010) Neuropsychological functioning in early-onset first-episode psychosis: comparison of diagnostic subgroups. Eur Arch Psychiatry Clin Neurosci 260:225–233PubMedCrossRefGoogle Scholar
- 49.Kravariti E, Reichenberg A, Morgan K, Dazzan P, Morgan C, Zanelli JW, Lappin JM, Doody GA, Harrison G, Jones PB, Murray RM, Fearon P (2009) Selective deficits in semantic verbal fluency in patients with a first affective episode with psychotic symptoms and a positive history of mania. Bipolar Disord 11:323–339PubMedCrossRefGoogle Scholar