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Profiles of neuropsychologic function in schizophrenia

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Abstract

In this article, the author reviews basic neuropsychologic issues in the study of schizophrenia. The first issue is whether cognitive dysfunction reflects a degenerative process or is a core feature of the disorder. Evidence demonstrating that cognitive difficulties are present at illness onset and are not caused by medication, illness progression, or other nonspecific factors is reviewed. The second question is less easily answered and deals with whether cognitive difficulties represent generalized dysfunction or differential deficits in specific neurocognitive domains. One difficulty in answering this question is the heterogeneous nature of the disorder. Clinical and cognitive subtyping approaches to reducing heterogeneity are discussed, with the conclusion that cognitive approaches hold the most promise for understanding subtype differences in neurobiologic substrates. Finally, the relation of cognitive ability to functional outcome is described, and it is explained why there is a resurgent interest in remediation efforts. The article closes with suggestions for future directions.

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References and Recommended Reading

  1. Kraepelin E: Dementia Praecox and Paraphrenia. Edinburgh: Livingston; 1925.

    Google Scholar 

  2. Saykin AJ, Gur RC, Gur RE, et al.: Neuropsychological function in schizophrenia: selective impairment in memory and learning. Arch Gen Psychiatry 1991, 48:618–624.

    PubMed  CAS  Google Scholar 

  3. Saykin AJ, Shtasel DL, Gur RE, et al.: Neuropsychological deficits in neuroleptic naive, first episode schizophrenic patients. Arch Gen Psychiatry 1994, 51:124–131.

    PubMed  CAS  Google Scholar 

  4. Spohn HE, Strauss ME: Relation of neuroleptic and anticholinergic medication to cognitive functions in schizophrenia. J Abnorm Psychol 1989, 98:367–380.

    Article  PubMed  CAS  Google Scholar 

  5. Goldberg TE, Weinberger DR: Effects of neuroleptic medications on the cognition of patients with schizophrenia: a review of recent studies. J Clin Psychiatry 1996, 57(suppl):62–65.

    PubMed  CAS  Google Scholar 

  6. Censits DM, Ragland JD, Gur RC, Gur RE: Neuropsychological evidence supporting a neurodevelopmental model of schizophrenia: a longitudinal study. Schizophr Res 1997, 24:289–298.

    Article  PubMed  CAS  Google Scholar 

  7. Harvey PD: Cognitive impairment in elderly patients with schizophrenia: age related changes. Int J Geriatr Psychiatry 2001, 16(suppl):S78-S85.

    Article  PubMed  Google Scholar 

  8. Kolb B, Whishaw IQ: Performance of schizophrenic patients on tests sensitive to left or right frontal, temporal, or parietal function in neurological patients. J Nerv Ment Dis 1983, 171:435–443.

    Article  PubMed  CAS  Google Scholar 

  9. Chapman LJ, Chapman JP: The measurement of differential deficits. J Psychiatry Res 1978, 14:303–311.

    Article  CAS  Google Scholar 

  10. McKay AP, McKenna PJ, Bentham P, et al.: Semantic memory is impaired in schizophrenia. Biol Psychiatry 1996, 39:929–937.

    Article  PubMed  CAS  Google Scholar 

  11. McKenna PJ, Tamlyn D, Lund CE, et al.: Amnesic syndrome in schizophrenia. Psychol Med 1990, 20:967–972.

    Article  PubMed  CAS  Google Scholar 

  12. Rund BR: Distractibility and recall capability in schizophrenics: a 4 year longitudinal study of stability in cognitive performance. Schizophr Res 1989, 2:265–275.

    Article  PubMed  CAS  Google Scholar 

  13. Blanchard JJ, Neale JM: The neuropsychological signature of schizophrenia: generalized or differential deficit? Am J Psychiatry 1994, 151:40–48.

    PubMed  CAS  Google Scholar 

  14. Heinrichs RW, Zakzanis KK: Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 1998, 12:426–445.

    Article  PubMed  CAS  Google Scholar 

  15. Bleuler E: Dementia Praecox or the Group of Schizophrenia. New York: International Universities Press; 1952.

    Google Scholar 

  16. Grube BS, Bilder RM, Goldman RS: Meta-analysis of symptom factors in schizophrenia. Schizophr Res 1998. 31:113–120.

    Article  PubMed  CAS  Google Scholar 

  17. Andreasen NC, Flaum M, Schultz S, et al.: Diagnosis, methodology and subtypes of schizophrenia. Neuropsychobiology 1997, 35:61–63.

    PubMed  CAS  Google Scholar 

  18. Goldberg TE, Weinberger DR: A case against subtyping in schizophrenia. Schizophr Res 1995, 17:147–152.

    Article  PubMed  CAS  Google Scholar 

  19. Buchanan RW, Strauss ME, Kirkpatrick B, et al.: Neuropsychological impairments in deficit vs. non-deficit forms of schizophrenia. Arch Gen Psychiatry 1994, 51:804–811.

    PubMed  CAS  Google Scholar 

  20. Hill SK, Ragland JD, Gur RC, Gur RE: Neuropsychological differences among empirically derived clinical subtypes of schizophrenia. Neuropsychology 2001, 15:502–509.

    Article  PubMed  Google Scholar 

  21. Mattson DT, Berk M, Lucas MD: A neuropsychological study of prefrontal lobe function in the positive and negative subtypes of schizophrenia. J Genet Psychol 1997, 158:487–494.

    Article  PubMed  CAS  Google Scholar 

  22. Zalewski C, Johnson-Selfridge MT, Ohriner S, et al.: A review of neuropsychological differences between paranoid and non-paranoid schizophrenia patients. Schizophr Bull 1998, 24:127–145.

    PubMed  CAS  Google Scholar 

  23. Heinrichs RW, Awad AW: Neurocognitive subtypes of chronic schizophrenia. Schizophr Res 1993, 9:49–58.

    Article  PubMed  CAS  Google Scholar 

  24. Goldstein G, Beers SR, Shemansky WJ: Neuropsychological differences between schizophrenic patients with heterogeneous Wisconsin Card Sorting Test Performance. Schizophr Res 1996, 21:13–18.

    Article  PubMed  CAS  Google Scholar 

  25. Goldstein G, Allen DN, Seaton BE: A comparison of clustering solutions for cognitive heterogeneity in schizophrenia. J Int Neuropsychol Soc 1998, 4:353–362.

    PubMed  CAS  Google Scholar 

  26. Seaton BE, Allen DN, Goldstein G, et al.: Relations between cognitive and symptom profile heterogeneity in schizophrenia. J Nerv Ment Dis 1999, 187:414–419.

    Article  PubMed  CAS  Google Scholar 

  27. Hill SK, Ragland JD, Gur RC, Gur RE: Neuropsychological profiles delineate distinct profiles of schizophrenia, an interaction between memory and executive function, and uneven distribution of clinical subtypes. J Clin Exp Neuropsychol 2002, 24:765–780. This study examined neuropsychologic performance in 151 patients with schizophrenia using cluster analysis to identify neurocognitive subtypes. Consistent with previous findings, two extreme clusters were characterized by near normative performance and profound global dysfunction, respectively. The two remaining neurocognitive clusters displayed moderate-to-severe dysfunction, and were differentiated by unique patterns of abstraction and flexibility, attention, spatial memory, and sensory perception.

    Article  PubMed  Google Scholar 

  28. Goldstein G: Neuropsychological heterogeneity in schizophrenia: a consideration of abstraction and problem-solving abilities. Arch Clin Neuropsychol 1990, 5:251–264.

    Article  PubMed  CAS  Google Scholar 

  29. Goldstein G, Shemansky WJ: Neuropsychological differences between schizophrenic patients with heterogeneous Wisconsin Card Sorting Test performance. Schizophr Res 1996, 21:13–18.

    Article  PubMed  CAS  Google Scholar 

  30. Turetsky BI, Moberg PJ, Mozley LH, et al.: Memory-delineated subtypes of schizophrenia: relationship to clinical, neuroanatomical, and neurophysiological measures. Neuropsychology 2002, 16:481–490. This study identified unimpaired, cortical, and subcortical patient subgroups based on patterns of verbal list-learning performance. The resulting cognitively derived subtypes could be distinguished based on symptomotology, structural, and functional brain measures.

    Article  PubMed  Google Scholar 

  31. Paulsen JS, Heaton RK, Sadek JR, et al.: The nature of learning and memory impairments in schizophrenia. J Int Neuropsychol Soc 1995, 1:88–99.

    Article  PubMed  CAS  Google Scholar 

  32. Green MF: What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 1996, 153:321–330.

    PubMed  CAS  Google Scholar 

  33. Lysaker P, Bell M, Beam-Goulet J: Wisconsin Card Sorting Test and work performance in schizophrenia. Schizophr Res 1995, 56:45–51.

    CAS  Google Scholar 

  34. Velligan DI, Bow-Thomas CC, Mahurin RK, et al.: Do specific neurocognitive deficits predict specific domains of community function in schizophrenia? J Nerv Ment Dis 2000, 188:518–524.

    Article  PubMed  CAS  Google Scholar 

  35. Bellack AS, Gold JM, Buchanan RW: Cognitive rehabilitation for schizophrenia: problems, prospects, and strategies. Schizophr Bull 1999, 25:257–274.

    PubMed  CAS  Google Scholar 

  36. Kurtz MM, Moberg PJ, Gur RC, Gur RE: Approaches to cognitive remediation of neuropsychological deficits in schizophrenia: a review and meta-analysis. Neuropsychol Rev 2001, 11:197–210. A meta-analysis was used to examine cognitive remediation effect sizes on executive, attention, and memory functions in schizophrenia. Effect sizes were moderate to large for all domains suggesting that cognitive difficulties are amenable to remediation efforts.

    Article  PubMed  CAS  Google Scholar 

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Ragland, J.D. Profiles of neuropsychologic function in schizophrenia. Curr Psychiatry Rep 5, 299–302 (2003). https://doi.org/10.1007/s11920-003-0059-4

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