Cluster analysis of cognitive deficits may mark heterogeneity in schizophrenia in terms of outcome and response to treatment

  • Elsa Gilbert
  • Chantal Mérette
  • Valérie Jomphe
  • Claudia Émond
  • Nancie Rouleau
  • Roch-Hugo Bouchard
  • Marc-André Roy
  • Thomas Paccalet
  • Michel Maziade
Original Paper


Cognitive impairments are central to schizophrenia, but their clinical utility for tagging heterogeneity in lifetime outcome and response to treatment is not conclusive. By exploiting four cognitive domains consistently showing large deficits in studies, we tested whether cluster analysis would define separate subsets of patients and then whether the disease heterogeneity marked by these clusters would be related to lifetime outcome and response to treatment. A total of 112 schizophrenia patients completed a neuropsychological evaluation. The PANSS, GAF-S and GAF-F were rated at the onset and endpoint of the illness trajectory. A blind judgment of the lifetime response to treatment was made. The first cluster presented near-normal cognitive performance. Two other clusters of severely impaired patients were identified: one generally impaired in the four cognitive domains and another selectively impaired in visual episodic memory and processing speed, each relating to a different lifetime evolution of disease and treatment response. Although the two impaired clusters were clinically indistinguishable in symptom severity and functioning at disease onset, patients with selective cognitive impairments demonstrated better improvement at outcome, whereas the generally impaired patients were more likely to be treatment refractory. The findings have implications for the management of patients and for clinical trials since particular combinations of cognitive deficits in patients would influence their treatment response.


Schizophrenia Heterogeneity Cognitive profiles Functioning Response to treatment 

Supplementary material

406_2013_463_MOESM1_ESM.doc (118 kb)
Supplementary material 1 (DOC 118 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Elsa Gilbert
    • 1
  • Chantal Mérette
    • 1
    • 2
  • Valérie Jomphe
    • 1
  • Claudia Émond
    • 1
  • Nancie Rouleau
    • 1
    • 3
  • Roch-Hugo Bouchard
    • 1
  • Marc-André Roy
    • 1
    • 2
  • Thomas Paccalet
    • 1
  • Michel Maziade
    • 1
    • 2
  1. 1.Centre de rechercheInstitut universitaire en santé mentale de QuébecQuebecCanada
  2. 2.Faculté de MédecineLaval UniversityQuebecCanada
  3. 3.École de psychologieUniversité LavalQuebecCanada

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