Abnormal subjective experiences in schizophrenia: its relationships with neuropsychological disturbances and frontal signs

  • Manuel J. Cuesta
  • Víctor Peralta
  • Jose A. Juan
Original Paper


The prevalence of abnormal subjective experiences is high in schizophrenic patients. This study starts from the hypothesis that these subjective disorders are associated with cognitive disturbances. In order to test this hypothesis a study was carried out on 40 patients who were diagnosed as suffering from schizophrenia according to RDC and DSM-III-R criteria. They were consecutively admitted due to a recrudescence of their symptomatology. Version 3 of the Frankfurt Complaint Questionnaire, adapted for Spanish by the authors, was used as an instrument for the assessment of subjective experiences. Eight patients refused to answer the questionnaire. A neuropsychological battery, including the Mini-Mental State, some subtests from the WAIS, Bender's visual-motor test, Rey's Complex Figure, and the Trail Making Test, was used. Frontal neurological signs were evaluated. The abnormal subjective experiences of schizophrenics presented a close association with neuropsychological disturbances and, to a lesser degree, of intensity with frontal neurological signs. Regression analyses by means of stepwise method and partial correlation analyses were undertaken. Many significant relationships between subjective experiences and cognitive disturbances persisted after controlling the influence of age, gender, education, lack of insight, neuroleptic doses, and biperidene doses.


Schizophrenia Significant Relationship Partial Correlation Close Association Schizophrenic Patient 
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  1. Addington J, Addington D, Marticka-Tyndale E (1991) Cognitive functioning and positive and negative symptoms in schizophrenia. Schizophr Res 5:123–134Google Scholar
  2. American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, (DSM-III-R), 3rd ed-revised. American Psychiatric Press, Washington DCGoogle Scholar
  3. Andreasen NC, Olsen S (1982) Negative versus positive schizophrenia: definition and validation. Arch Gen Psychiatry 39: 789–794Google Scholar
  4. Andreasen NC (1990) Positive and negative symptoms in schizophrenia. A critical reappraisal. Arch Gen Psychiatry 47:615–621Google Scholar
  5. Bender L (1947) Instructions for the use of Visual Motor Gestalt Test. American Orthopsychiatric Association, New York. (El test guestáltico visuomotor de Bender. Uso y aplicaciones clínicas, 1974, Sexta edition, Paidos, Buenos Aires)Google Scholar
  6. Benson DF, Stuss DT (1982) Motor abilities after frontal leukotomy. Neurology 32:1353–1357Google Scholar
  7. Bitter I, Jaeger J, Agdeppa J, Volavka J (1989) Subjective symptoms: part of the negative syndrome of schizophrenia? Psychopharm Bull 25:180–185Google Scholar
  8. Brenner HD (1989) The treatment of basic psuchological dysfunctions from a systemic point of view. Br J Psychiatry 155 (Suppl 5):74–82Google Scholar
  9. Chapman J (1966) The early symptoms of schizophrenia. Br J Psychiatry 112:225–231Google Scholar
  10. Christensen A (1978) Luria's neuropsychological investigation. led. Munksgaard, Copenhagen. (El diagnóstico neuropsicológico de Luria, ed Pablo del Río, Madrid)Google Scholar
  11. Crow TJ (1980) Molecular pathology of schizophrenia: more than one disease. Br Med J 280:66–68Google Scholar
  12. Cuesta MJ, Peralta V (1994): Lack of, insight in schizophrenia. Schizophr Bull 20(2):359–366Google Scholar
  13. Cuesta MJ, Peralta V (1995) Cognitive disorders in the positive, negative and disorganization schizophrenic syndromes. Psychiatry Res 58:227–235Google Scholar
  14. Cutting J, Dunne F (1989) Subjective experience of schizophrenia. Schizophr Bull 15:217–231Google Scholar
  15. Davis JM (1976) Comparative drugs and costs of antipsychotic medication. Arch Gen Psychiatry 33:858–861Google Scholar
  16. De Leon J, Wilson WH, Simpson GM (1991) Negative symptoms, defect state and Huber's basic symptoms: a comparison of the concepts. Psychiatry Q 62:277–297Google Scholar
  17. Ebel H, Gross G, Klosterkötter J, Huber G (1989) Basic symptoms in schizophrenic and affective psychoses. Psychopathology 22: 224–232Google Scholar
  18. Faustman WO, Moses JA, Ringo DL, Newcomer JW (1991) Lefthandedness in male schizophrenic patients is associated with increased impairment on the Luria-Nebraska neuropsychological battery. Biol Psychiatry 30:326–334Google Scholar
  19. Goldberg E, Bilder R, Jaeger J (1987) The executive dyscontrol battery and its applications. J Clin Exp Neuropsychol 9:38–48Google Scholar
  20. Green M, Walker E (1985) Neuropsychological performance and positive and negative symptoms in schizophrenia. J Abnorm Psychol 94:460–469Google Scholar
  21. Gross G, Huber G, Klosterkötter J et al. (1987) Bonner Skala für die Beurteilung von Basissymtomen. (SABS: Bonn Scale for the Assessment of Basic Symptoms). Springer, Berlin Heidelberg New YorkGoogle Scholar
  22. Grove WM, Andreasen NC (1982) Simultaneous tests of many hypotheses in exploratory research. J Nerv Ment Dis 170(1):3–9Google Scholar
  23. Guy W, Ban TA (1979) The AMDP System. Springer, Berlin Heidelberg New YorkGoogle Scholar
  24. Hasse-Sender I, Gross G, Huber G et al. (1982) Testpsychologische Untersuchungen in Bassistadien und reinen Residualzuständen schizophrener Erkrankungen. Arch Psychiatr, Nervekr 231:235–249Google Scholar
  25. Heinrichs DW, Buchanan RW (1988) Significance and meaning of neurological signs in schizophrenia. Am J Psychiatry 145:11–18Google Scholar
  26. Huber G (1957) Pneumenzephalographische und psychopathologische Bilder bei endogenen psychosen. Springer, Berlin Heidelberg New YorkGoogle Scholar
  27. Huber G (1966) Reine Defectsyndrome und Bassistadien endogener Psychosen. Fortschr Neurol Psychiatr 34:409–426Google Scholar
  28. Keilp JG, Seeney JA, Jacobsen P, Solomon C, St. Louis L, Deck M, Frances A, Mann J (1988) Cognitive impairment in schizophrenia: specific relations to ventricular size and negative symptomatology. Biol Psychiatry 24:47–55Google Scholar
  29. Kennard MA (1960) Value of equivocal signs in neurological diagnosis. Neurology 10:753–764Google Scholar
  30. Kick MA (1991) Psychopathologie und Verlauf der Postakuten Schizophrenie. Springer, Berlin Heidelberg New YorkGoogle Scholar
  31. Koehler K, Sauer H (1984) Huber's basic symptoms: another approach to negative psychopathology in schizophrenia. Compr Psychiatry 25:176–182Google Scholar
  32. Kolakowska T, Williams AO, Ardern M (1985) Schizophrenic with good and poor outcome. III. Neurological “soft” signs. Cognitive impairment and their clinical significance. Br J Psychiatry 146:348–357Google Scholar
  33. Kolb B, Winshaw Q (1983) Performance of schizophrenic patients on test sensibles to left and right frontal, temporal or parietal function in neurological patients. J Nerv Ment Dis 171:435–443Google Scholar
  34. Kraepelin E (1919). Dementia praecox and paraphrenia (tranls. by R. Mary Barclay from Psychiatrie, 8th edn, 1913). Livingstone EdinburghGoogle Scholar
  35. Landmark I (1982) A manual for the assessment of schizophrenia. Acta Psychiatr Scand 298 (Suppl 65):1–88Google Scholar
  36. Lobo Ac Ezquerra J, Escobar V, Sala JM, Seva A (1979) El mini examen cognoscitivo: Un test simple y práctico para dectectar defectos cognitivos. Comunicación Psiquiátrica 3:73–79Google Scholar
  37. Liddle PF (1987) Schizophrenic syndromes, cognitive performance and neurological dysfunction. Psychol Med 17:49–57Google Scholar
  38. Liddle PF, Barnes TRE (1988) The subjective experience of deficits in schizophrenia. Compr Psychiatry 29:157–164Google Scholar
  39. Manschreck TC, Ames D (1984) Neurological features and psychopathology in schizophrenic disorders. Biol Psychiatry 19: 703–719Google Scholar
  40. Merriam AE, Kay S, Opler LA, Kushner SF, van Praag M (1990) Neurological signs and the positive-negative dimension in schizophrenia. Biol Psychiatry 28:181–192Google Scholar
  41. McGie A, Chapman J (1961) Disorders of attention and perception in early schizophrenia. Br J Med Psychol 34:103–116Google Scholar
  42. Mosher L, Pollin W, Stanebau J (1971) Identical twins discordant for schizophrenia: neurological findings. Arch Gen Psychiatry 24:422–430Google Scholar
  43. Mundt CH, Kasper S, Huerkamp M (1989) The diagnostic specificity of negative symptoms and their psychopathological context. Br J Psychiatry 155 (Suppl 7):32–36Google Scholar
  44. Norusis MJ (1986) The Statistical Package for Social Sciences (SPSS/PC+). Manual of reference. SPSS Inc, ChicagoGoogle Scholar
  45. Oldfield RC (1971) The assessment and analysis of handedness: the Edinburgh Inventory. Neuropsychologia 9:97–113Google Scholar
  46. Owens DG, Johnstone EC (1980) The disabilities of chronic schizophrenia — their nature and factors contributing to their development. Br J Psychiatry 136:384–395Google Scholar
  47. Peralta V, Cuesta MJ (1989a) Trastornos cognitivos en la esquizofrenia: valoración por medio del inventario psicopatológico de Frankfurt. Resultados iniciales. Actas Luso-Españolas de Neurología, Psiquiatría y Ciencias Afines 17:255–262Google Scholar
  48. Peralta V, Cuesta MJ (1989b) El valor pronóstico de los trastornos cognitivos en la esquizofrenia evaluados por medio del Inventario Psicopatológico de Frankfurt. Revista de Psiquiatría de la Facultad de Medicina de Barcelona 16:295–302Google Scholar
  49. Peralta V, Cuesta MJ (1991) Schneiderian versus Bleurian schizophrenia and basic symptoms. Psychopathology 24:151–157Google Scholar
  50. Peralta V, Cuesta MJ (1994) Subjective experiences in schizophrenia: a critical review. Compr Psychiatry 35:198–204Google Scholar
  51. Petho B, Bitter I (1985) Types of complaints in psychiatric and internal medical patients. Psychopathology 18:241–253Google Scholar
  52. Reitan RM (1978) Manual for administration of neuropsychological test batteries for adult and children. Reitan Neuropsychology Laboratories, Inc, Tucson, ArizonaGoogle Scholar
  53. Rey A (1959) Test de Copie et de Reproduction de Mémoire de Figures Géometriques Complexes. [El test de copia de una Figura Compleja (1980) TEA, Madrid]Google Scholar
  54. Rochford JM, Detre T, Tucker GJ, Harrow M (1970) Neuropsychological impairments in functional diseases. Arch Psychiatry 22:114–119Google Scholar
  55. Royall DR, Mahurin RK, True JE, Anderson B, Brock IP, Freeburger L, Miller A (1993) Executive impairment among the functionally dependent: comparisons between schizophrenic and elderly subjects. Am Psychiatry 150:1813–1819Google Scholar
  56. Schröder J, Niethammer R, Geider FJ, Reitz C, Binkert M, Jauss M, Sauer H (1992) Neurological soft signs in schizophrenia. Schizophr Res 6:25–30Google Scholar
  57. Selten JP, Sijben AE, van den Bosch RJ (1991) Subjective experience of negative symptoms. Biol Psychiatry 29:404SGoogle Scholar
  58. Spitzer RL, Endicott J, Robins E (1978) Research diagnostic criteria (RDC) for a selected group of functional disorders, 3rd edn. New York State Psychiatric Institute, New YorkGoogle Scholar
  59. Strauss JS, Carpenter WT Jr (1974) The prediction of outcome in schizophrenia. II Relationship between predictor and outcome variables. Arch Gen Psychiatry 31:37–42Google Scholar
  60. Sülwold L (1985) Schizophrenic basic disturbances: psychological aspects the type of “psychological deficiency”. In: Pichot P, Berner P, Wolf R, Thau K (eds) Psychiatry. The state of the art, vol 1 Plenum Press, New York and London, pp 473–475Google Scholar
  61. Sülwold L (1986) Frankfurter Bechswerde-Fragebogen (3). In: Sülwold L, Huber G (eds) Schizophrene Bassistörungen. Springer, Berlin Heidelberg New YorkGoogle Scholar
  62. van den Bosch RJ, Rozendaal N (1988) Subjective cognitive dysfunction, eye tracking and slow brain potentials in schizophrenic and schizoaffective patients. Biol Psychiatry 24:741–746Google Scholar
  63. Wagman AMI, Heinrichs DW, Carpenter WT (1987) Deficit and nondeficit forms of schizophrenia: Neuropsychological evaluation. Psychiatry Res 22:319–330Google Scholar
  64. Wechsler D (1955) Manual for the Wechsler Adult Intelligence Scale. The Psychological Corporation, New York (WAIS, 1990, TEA Ediciones SA, 8a edición).Google Scholar
  65. Woods BT, Berman KF, Zec RF (1986) Physiologic dysfunctions of dorsolateral prefrontal cortex in schizophrenia. I. Regional cerebral blood flow evidence. Arch Gen Psychiatry 43:647–663Google Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Manuel J. Cuesta
    • 1
  • Víctor Peralta
    • 1
  • Jose A. Juan
    • 1
  1. 1.Psychiatric UnitVirgen del Camino HospitalPamplonaSpain

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