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Mohn C, Ueland T, Haatveit B, Sæther LS, Lagerberg TV, Andreassen OA, Melle I, Vaskinn A. Neurocognitive function and delusion severity in schizophrenia spectrum disorders. Schizophr Res 2024; 270:172-177. [PMID: 38917554 DOI: 10.1016/j.schres.2024.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 06/07/2024] [Accepted: 06/16/2024] [Indexed: 06/27/2024]
Abstract
The role of basic neurocognitive function in delusions is unclear despite the association to difficulties in reasoning and decision-making. We investigated 812 individuals with schizophrenia spectrum disorders (SSD) using a broad neuropsychological test battery encompassing motor and mental processing speed, working memory, learning and memory, and executive function. Premorbid and current intellectual function was assessed with NART and WASI. Delusion level and other clinical symptoms were measured with the PANSS and GAF. Hierarchical and k-means cluster analysis using standardized scores showed the presence of two separate clusters where the group with the higher delusion level (n = 291) was characterized by more severe neurocognitive deficits (>1.5 standard deviations below the healthy control mean), higher PANSS scores, lower GAF scores, and lower intelligence levels compared to the cluster with mild impairments (n = 521). We conclude that a higher delusion level is related to neurocognitive deficits across domains. Further, the validity of the two separate clusters was indicated by significant differences in clinical symptoms, everyday function, and intellectual ability. Compared to those with mild delusion levels, SSD patients with higher delusion levels seem particularly disadvantaged, with co-occurring general symptoms and lower daily function, underscoring the need for clinical and psychosocial support programs. A limitation of this study is the cross sectional design. Longitudinal studies are needed to determine the causal relationship between delusions and neurocognitive function.
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Affiliation(s)
- Christine Mohn
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Norway; National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway.
| | - Torill Ueland
- Norwegian Centre for Mental Disorders Research, Psychosis Research Section, Division of Mental Health and Addiction, Oslo University Hospital, Norway; Department of Psychology, University of Oslo, Norway
| | - Beathe Haatveit
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Norway; Norwegian Centre for Mental Disorders Research, Psychosis Research Section, Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Linn Sofie Sæther
- Norwegian Centre for Mental Disorders Research, Psychosis Research Section, Division of Mental Health and Addiction, Oslo University Hospital, Norway; Department of Psychology, University of Oslo, Norway
| | - Trine Vik Lagerberg
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Norway; Norwegian Centre for Mental Disorders Research, Psychosis Research Section, Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Norway; Norwegian Centre for Mental Disorders Research, Psychosis Research Section, Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Norway; National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway
| | - Anja Vaskinn
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Norway; Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, Norway
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2
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Vaskinn A, Sundet K, Haatveit B. Social cognitive heterogeneity in schizophrenia: A cluster analysis. Schizophr Res Cogn 2022; 30:100264. [PMID: 35832256 PMCID: PMC9272020 DOI: 10.1016/j.scog.2022.100264] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/27/2022] Open
Abstract
This study examined social cognitive heterogeneity in Norwegian sample of individuals with schizophrenia (n = 82). They were assessed with three social cognitive tests: Emotion in Biological Motion (emotion processing), Relationships Across Domains (social perception), and Movie for the Assessment of Social Cognition (theory of mind). Hierarchical and k-means cluster analyses using standardized scores on these three tests provided two clusters. The first cluster (68 %) had mild social cognitive impairments (<0.5 standard deviations below healthy comparison participants). The second cluster (32 %) had severe social cognitive impairments (>2 standard deviations below healthy comparison participants). Validity of the two social cognitive subgroups was indicated by significant differences in functioning, symptom load and nonsocial cognition. Our study shows that social cognitive tests can be used for clinical and cognitive subtyping. This is of potential relevance for treatment.
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Affiliation(s)
- Anja Vaskinn
- Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Norway
- Corresponding author at: Oslo University Hospital, Division Mental Health and Addiction, Centre for Research and Education in Forensic Psychiatry, PO Box 4956 Nydalen, 0424 Oslo, Norway.
| | - Kjetil Sundet
- Department of Psychology, University of Oslo, Norway
| | - Beathe Haatveit
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Norway
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3
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Daderwal MC, Sreeraj VS, Suhas S, Rao NP, Venkatasubramanian G. Montreal Cognitive Assessment (MoCA) and Digit Symbol Substitution Test (DSST) as a screening tool for evaluation of cognitive deficits in schizophrenia. Psychiatry Res 2022; 316:114731. [PMID: 35926360 DOI: 10.1016/j.psychres.2022.114731] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 07/02/2022] [Accepted: 07/16/2022] [Indexed: 11/28/2022]
Abstract
Cognitive deficit is one of the core features of schizophrenia and is associated with poor functional outcomes. There is a lack of validated criteria to screen and monitor cognitive deficits in schizophrenia. This study aimed to evaluate the concurrent validity and sensitivity of MoCA (Montreal Cognitive Assessment) and DSST (Digit Symbol Substitution Test) in identifying cognitive deficits in Schizophrenia comparing with a comprehensive MCCB [MATRICS (Measurement And Treatment Research to Improve Cognition in Schizophrenia) Consensus Cognitive Battery] equivalent battery. We did clinical and cognitive assessments on 30 patients with schizophrenia and 30 age and gender-matched healthy controls. The Cronbach's Alpha of MoCA was 0.839, and on adding the DSST, it increased to 0.859. In stepwise binary logistic regression, adding DSST to MoCA improved the prediction of cognitive impairment as defined by a comprehensive battery with 86.7% classification accuracy. Receiver operating characteristic curve analysis suggested a score of 25 of MoCA and 59 of DSST as an optimal cut-off in identifying severe cognitive deficits with an additional MoCA cut-off of 27 for identifying mild cognitive deficits. Combined MoCA and DSST is a sensitive and quick method to screen for neurocognitive deficits in schizophrenia.
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Affiliation(s)
| | - Vanteemar S Sreeraj
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India.
| | - Satish Suhas
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
| | - Naren P Rao
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
| | - Ganesan Venkatasubramanian
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, India
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4
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Zhuo C, Tian H, Chen J, Li Q, Yang L, Zhang Q, Chen G, Cheng L, Zhou C, Song X. Associations of cognitive impairment in patients with schizophrenia with genetic features and with schizophrenia-related structural and functional brain changes. Front Genet 2022; 13:880027. [PMID: 36061201 PMCID: PMC9437456 DOI: 10.3389/fgene.2022.880027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Cognitive impairment is highly prevalent in patients with major psychiatric disorders (MPDs), including schizophrenia (SCZ), bipolar disorder, major depressive disorder, in whom it can be highly disruptive to community functioning and worsen prognosis. Previously, genetic factors and cognitive impairments in MPD patients have been examined mostly in isolated circuits rather than in the whole brain. In the present study, genetic, neuroimaging, and psychometric approaches were combined to investigate the relationship among genetic factors, alterations throughout the brain, and cognitive impairments in a large cohort of patients diagnosed with SCZ, with a reference healthy control (HC) group. Single nucleotide polymorphisms (SNPs) in SCZ-risk genes were found to be strongly related to cognitive impairments as well as to gray matter volume (GMV) and functional connectivity (FC) alterations in the SCZ group. Annotating 136 high-ranking SNPs revealed 65 affected genes (including PPP1R16B, GBBR2, PDE4B, CANCNA1C, SLC12AB, SATB2, MAG12, and SATB2). Only one, a PDE4B SNP (rs1006737), correlated with GMV (r = 0:19 p = 0.015) and FC (r = 0.21, p = 0.0074) in SCZ patients. GMV and FC alterations correlated with one another broadly across brain regions. Moreover, the present data demonstrate three-way SNP-FC-GMV associations in patients with SCZ, thus providing clues regarding potential genetic bases of cognition impairments in SCZ. SNP-FC-GMV relationships correlated with visual learning and reasoning dimensions of cognition. These data provide evidence that SCZ-related cognitive impairments may reflect genetically underlain whole-brain structural and functional alterations.
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Affiliation(s)
- Chuanjun Zhuo
- Key Laboratory of Real Time Tracing of Brian Circuits in Psychiatry and Neurology (RTBNP_Lab), Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
- Digital Analysis Center of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
- Department of Psychiatry and Neurology Imaging-Genetics and Comorbidity Laboratory (PNGC_Lab) of Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Deep Learning Center of MRI and Genetics, Wenzhou Seventh People’s Hospital, Wenzhou, China
- *Correspondence: Chuanjun Zhuo, ; Xueqin Song,
| | - Hongjun Tian
- Department of Psychiatry, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
| | - Jiayue Chen
- Department of Psychiatry, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
| | - Qianchen Li
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lei Yang
- Department of Psychiatry, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
| | - Qiuyu Zhang
- Department of Psychiatry, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Fourth Center Hospital, Tianjin, China
| | - Guangdong Chen
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou, China
| | - Langlang Cheng
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Chuanjun Zhuo, ; Xueqin Song,
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5
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Sahl AC, Rognlien HF, Andreassen OA, Melle I, Ueland T, Vaskinn A. Theory of mind in schizophrenia: a comparison of subgroups with low and high IQ. Nord J Psychiatry 2022; 77:329-335. [PMID: 35916656 DOI: 10.1080/08039488.2022.2106512] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND Social cognitive impairment is common in schizophrenia, but it is unclear if it is present in individuals with high IQ. This study compared theory of mind (ToM) in schizophrenia participants with low or high IQ to healthy controls. METHODS One hundred and nineteen participants (71 healthy controls, 17 high IQ (IQ ≥115), and 31 low IQ (IQ ≤95) schizophrenia participants) were assessed with the Movie for the Assessment of Social Cognition, providing scores for total, cognitive, and affective ToM, along with overmentalizing, undermentalizing, and no-mentalizing errors. IQ was measured with Wechsler Abbreviated Scale of Intelligence; clinical symptoms with the Positive and Negative Syndrome Scale. RESULTS Healthy controls performed better than the low IQ schizophrenia group for all ToM scores, and better than the high IQ schizophrenia group for the total score and under- and no-mentalizing errors. The high IQ group made fewer overmentalizing errors and had better total and cognitive ToM than the low IQ group. Their number of overmentalizing errors was indistinguishable from healthy controls. CONCLUSION Global ToM impairment was present in the low IQ schizophrenia group. Overmentalizing was not present in the high IQ group and appears related to lower IQ. Intact higher-level reasoning may prevent the high IQ group from making overmentalizing errors, through self-monitoring or inhibition. We propose that high IQ patients are chiefly impaired in lower-level ToM, whereas low IQ patients also have impaired higher-level ToM. Conceivably, this specific impairment could help explain the lower functioning reported in persons with intact IQ.
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Affiliation(s)
- André C Sahl
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Henning F Rognlien
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torill Ueland
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Anja Vaskinn
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway
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Carruthers SP, Van Rheenen TE, Karantonis JA, Rossell SL. Characterising Demographic, Clinical and Functional Features of Cognitive Subgroups in Schizophrenia Spectrum Disorders: A Systematic Review. Neuropsychol Rev 2021; 32:807-827. [PMID: 34694542 DOI: 10.1007/s11065-021-09525-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 08/02/2021] [Indexed: 11/24/2022]
Abstract
Considerable cognitive heterogeneity is present within the schizophrenia spectrum disorder (SSD) population. Several subgroups characterised by more homogenous cognitive profiles have been identified. It is not yet clear however, whether these subgroups represent different points along a continuum of cognitive symptom severity, or whether they reflect unique profiles of the disorder. One way to determine this is by comparing subgroups on their non-cognitive characteristics. The aim of the present review was to systematically summarise our current understanding of the non-cognitive features of the cognitive subgroups of schizophrenia spectrum disorder (SSD). Thirty-five relevant studies were identified from January 1980 to March 2020. Cognitive subgroups were consistently compared on age, sex, education, age of illness onset, illness duration, positive, negative and disorganised symptoms, depression and psychosocial functioning. It was revealed that subgroups were consistently distinguished by education, negative symptom severity and degree of functional impairment; with subgroups characterised by worse cognitive functioning performing/rated worse on these characteristics. The lack of consistent subgroup differences for the majority of the non-cognitive characteristics provides partial support for the notion that cognitive subgrouping in SSD is not simply reflecting a rehash of previously identified clinical subtypes. However, as subgroups were consistently distinguished by three characteristics known to be associated with cognition, our understanding of the extent to which the cognitive subgrouping approach is representing separate subtypes versus subdivisions along a continuum of symptom severity is still not definitive.
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Affiliation(s)
- Sean P Carruthers
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.
| | - Tamsyn E Van Rheenen
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, 3053, Australia
| | - James A Karantonis
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, 3053, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne VIC, Australia
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7
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Leweke FM, Rohleder C, Gerth CW, Hellmich M, Pukrop R, Koethe D. Cannabidiol and Amisulpride Improve Cognition in Acute Schizophrenia in an Explorative, Double-Blind, Active-Controlled, Randomized Clinical Trial. Front Pharmacol 2021; 12:614811. [PMID: 33995015 PMCID: PMC8117353 DOI: 10.3389/fphar.2021.614811] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 03/08/2021] [Indexed: 12/17/2022] Open
Abstract
Cannabidiol (CBD), a principal phytocannabinoid constituent, has demonstrated antipsychotic properties in recent clinical trials. While it has also been suggested a promising candidate for the treatment of neurodegenerative disorders, it failed to demonstrate efficacy in cognitive impairments associated with schizophrenia as an add-on treatment (600 mg/day for 6 weeks) in 18 chronically ill patients co-treated with a variety of psychopharmacologic drugs. Here, we report on the results of parallel-group, active-controlled, mono-therapeutic, double-blind, randomized clinical trial (CBD-CT1; ClinicalTrials.gov identifier: NCT00628290) in 42 acute paranoid schizophrenic patients receiving either CBD (up to 800 mg/day) or amisulpride (AMI, up to 800 mg/day) for four weeks in an inpatient setting with neurocognition as a secondary objective. Twentynine patients (15 and 14 in the CBD and AMI group, respectively) completed two cognitive assessments at baseline and the end of the treatment period. We investigated the following cognitive domains: pattern recognition, attention, working memory, verbal and visual memory and learning, processing speed, and verbal executive functions. When applying the Bonferroni correction for multiple testing, p < 0.0004 would indicate statistical significance. There was no relevant difference in neurocognitive performance between the CBD and the AMI group at baseline, and we observed no post-treatment differences between both groups. However, we observed improvements within both groups from pre-to post-treatment (standardized differences reported as Cohen’s d) in visual memory (CBD: 0.49, p = 0.015 vs. AMI: 0.63, p = 0.018) and processing speed (CBD: 0.41, p = 0.004 vs. AMI: 0.57, p = 0.023). Furthermore, CBD improved sustained attention (CBD: 0.47, p = 0.013, vs. AMI: 0.52, p = 0.085), and visuomotor coordination (CBD: 0.32, p = 0.010 vs. AMI: 0.63, p = 0.088) while AMI led to enhanced working memory performance in two different paradigms (Subject Ordered Pointing Task–AMI: 0.53, p = 0.043 vs. CBD: 0.03, p = 0.932 and Letter Number Sequencing–AMI: 0.67, p = 0.017 vs. CBD: 0.08 p = 0.755). There was no relevant correlation between changes in neurocognitive parameters and psychotic symptoms or anandamide serum levels. This study shows that both CBD and AMI improve neurocognitive functioning with comparable efficacy in young and acutely ill schizophrenia patients via an anandamide-independent mechanism.
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Affiliation(s)
- F Markus Leweke
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany.,Youth Mental Health Team, Brain and Mind Centre, Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Cathrin Rohleder
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany.,Youth Mental Health Team, Brain and Mind Centre, Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Christoph W Gerth
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of General Psychiatry, Rheinhessen-Fachklinik Alzey, Alzey, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ralf Pukrop
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Dagmar Koethe
- Youth Mental Health Team, Brain and Mind Centre, Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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8
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Cognitive Heterogeneity across Schizophrenia and Bipolar Disorder: A Cluster Analysis of Intellectual Trajectories. J Int Neuropsychol Soc 2020; 26:860-872. [PMID: 32423506 DOI: 10.1017/s1355617720000442] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Cognitive dysfunction cut across diagnostic categories and is present in both schizophrenia and bipolar disorder, although with considerable heterogeneity in both disorders. This study examined if distinct cognitive subgroups could be identified across schizophrenia and bipolar disorder based on the intellectual trajectory from the premorbid phase to after illness onset. METHOD Three hundred and ninety-eight individuals with schizophrenia (n = 223) or bipolar I disorder (n = 175) underwent clinical and neuropsychological assessment. Hierarchical and k-means cluster analyses using premorbid (National Adult Reading Test) and current IQ (Wechsler Abbreviated Scale of Intelligence) estimates were performed for each diagnostic category, and the whole sample collapsed. Resulting clusters were compared on neuropsychological, functional, and clinical variables. Healthy controls (n = 476) were included for analyses of neuropsychological performance. RESULTS Cluster analyses consistently yielded three clusters: a relatively intact group (36% of whole sample), an intermediate group with mild cognitive impairment (44%), and an impaired group with global deficits (20%). The clusters were validated by multinomial logistic regression and differed significantly for neuropsychological, functional, and clinical measures. The relatively intact group (32% of the schizophrenia sample and 42% of the bipolar sample) performed below healthy controls for speeded neuropsychological tests. CONCLUSIONS Three cognitive clusters were identified across schizophrenia and bipolar disorder using premorbid and current IQ estimates. Groups differed for clinical, functional, and neuropsychological variables, implying their meaningfulness. One-third of the schizophrenia sample belonged to the relatively intact group, highlighting that neuropsychological assessment is needed for the precise characterization of the individual.
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9
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Wortinger LA, Engen K, Barth C, Lonning V, Jørgensen KN, Andreassen OA, Haukvik UK, Vaskinn A, Ueland T, Agartz I. Obstetric complications and intelligence in patients on the schizophrenia-bipolar spectrum and healthy participants. Psychol Med 2020; 50:1914-1922. [PMID: 31456537 PMCID: PMC7477368 DOI: 10.1017/s0033291719002046] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/27/2019] [Accepted: 07/24/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Whether severe obstetric complications (OCs), which harm neural function in offspring, contribute to impaired cognition found in psychiatric disorders is currently unknown. Here, we sought to evaluate how a history of severe OCs is associated with cognitive functioning, indicated by Intelligence Quotient (IQ). METHODS We evaluated the associations of a history of OCs and IQ in 622 healthy controls (HC) and 870 patients on the schizophrenia (SCZ) - bipolar disorder (BIP) spectrum from the ongoing Thematically Organized Psychosis study cohort, Oslo, Norway. Participants underwent assessments using the NART (premorbid IQ) and the WASI (current IQ). Information about OCs was obtained from the Medical Birth Registry of Norway. Multiple linear regression models were used for analysis. RESULTS Severe OCs were equally common across groups. SCZ patients with OCs had lower performances on both premorbid and current IQ measures, compared to those without OCs. However, having experienced more than one co-occurring severe OC was associated with lower current IQ in all groups. CONCLUSIONS Severe OCs were associated with lower IQ in the SCZ group and in the BIP and HC groups, but only if they had experienced more than one severe OC. Low IQ might be a neurodevelopmental marker for SCZ; wherein, severe OCs influence cognitive abilities and increase the risk of developing SCZ. Considering OCs as a variable of neurodevelopmental risk for severe mental illness may promote the development of neuroprotective interventions, improve outcome in vulnerable newborns and advance our ability to make clinical prognoses.
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Affiliation(s)
- Laura Anne Wortinger
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristine Engen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Claudia Barth
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Vera Lonning
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kjetil Nordbø Jørgensen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A. Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Unn Kristin Haukvik
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anja Vaskinn
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torill Ueland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institute, Stockholm, Sweden
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10
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Vaskinn A, Horan WP. Social Cognition and Schizophrenia: Unresolved Issues and New Challenges in a Maturing Field of Research. Schizophr Bull 2020; 46:464-470. [PMID: 32133507 PMCID: PMC7147571 DOI: 10.1093/schbul/sbaa034] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Social cognition has become a topic of widespread interest in experimental and treatment research in schizophrenia over the past 15 years. This explosion of interest largely reflects the robust evidence that social cognition is among the strongest known correlates of poor community functioning throughout the course of schizophrenia. While progress has been impressive, we consider several fundamental questions about the scope, structure, and optimal measurement of social cognition that remain unanswered and point to the need for continued method development. We also consider more recently emerging questions about individual differences, ecological and cross-cultural validity, and intervention approaches, as well as broader technological changes that impact how we understand and use social cognition at a societal level. Continued efforts to creatively grapple with the complexities and challenges the field now faces hold great promise for helping us understand and more effectively treat a major source of functional disability in schizophrenia.
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Affiliation(s)
- Anja Vaskinn
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway,To whom correspondence should be addressed; tel: + 47 23 02 73 31, fax: + 47 23 02 73 33,
| | - William P Horan
- VeraSci Inc, Durham, NC,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
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11
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McCleery A, Nuechterlein KH. Cognitive impairment in psychotic illness: prevalence, profile of impairment, developmental course, and treatment considerations
. DIALOGUES IN CLINICAL NEUROSCIENCE 2019; 21:239-248. [PMID: 31749648 PMCID: PMC6829172 DOI: 10.31887/dcns.2019.21.3/amccleery] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Despite effective pharmacological treatments for psychotic symptoms (eg, hallucinations, delusions), functional outcomes for people with psychotic disorders are often disappointing. Although it is not included in the diagnostic criteria for psychotic disorders, cognitive impairment is one of the strongest determinants of community functioning in this clinical population, and thus it is an important target for intervention. In this review, we discuss the major areas of research regarding impaired cognition in psychotic illness. The specific topics covered include: (i) the prevalence of cognitive impairment in psychotic disorders; (ii) the profile and magnitude of cognitive impairment in psychotic disorders; (iii) the developmental course of cognitive impairment; (iv) the longitudinal stability of cognitive impairment; and (v) treatment approaches to improve cognitive performance in people with psychotic disorders.
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Affiliation(s)
- Amanda McCleery
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, US; VA Greater Los Angeles, VISN 22 MIRECC, Los Angeles, California, US
| | - Keith H Nuechterlein
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, US; UCLA Department of Psychology, Los Angeles, California, US
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12
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Genome-wide analysis reveals extensive genetic overlap between schizophrenia, bipolar disorder, and intelligence. Mol Psychiatry 2019; 25:844-853. [PMID: 30610197 PMCID: PMC6609490 DOI: 10.1038/s41380-018-0332-x] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/18/2018] [Accepted: 11/29/2018] [Indexed: 02/08/2023]
Abstract
Schizophrenia (SCZ) and bipolar disorder (BD) are severe mental disorders associated with cognitive impairment, which is considered a major determinant of functional outcome. Despite this, the etiology of the cognitive impairment is poorly understood, and no satisfactory cognitive treatments exist. Increasing evidence indicates that genetic risk for SCZ may contribute to cognitive impairment, whereas the genetic relationship between BD and cognitive function remains unclear. Here, we combined large genome-wide association study data on SCZ (n = 82,315), BD (n = 51,710), and general intelligence (n = 269,867) to investigate overlap in common genetic variants using conditional false discovery rate (condFDR) analysis. We observed substantial genetic enrichment in both SCZ and BD conditional on associations with intelligence indicating polygenic overlap. Using condFDR analysis, we leveraged this enrichment to increase statistical power and identified 75 distinct genomic loci associated with both SCZ and intelligence, and 12 loci associated with both BD and intelligence at conjunctional FDR < 0.01. Among these loci, 20 are novel for SCZ, and four are novel for BD. Most SCZ risk alleles (61 of 75, 81%) were associated with poorer cognitive performance, whereas most BD risk alleles (9 of 12, 75%) were associated with better cognitive performance. A gene set analysis of the loci shared between SCZ and intelligence implicated biological processes related to neurodevelopment, synaptic integrity, and neurotransmission; the same analysis for BD was underpowered. Altogether, the study demonstrates that both SCZ and BD share genetic influences with intelligence, albeit in a different manner, providing new insights into their genetic architectures.
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13
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Rund BR. The research evidence for schizophrenia as a neurodevelopmental disorder. Scand J Psychol 2018; 59:49-58. [PMID: 29356007 DOI: 10.1111/sjop.12414] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/26/2017] [Indexed: 01/27/2023]
Abstract
Schizophrenia is a neurodevelopmental disorder that starts very early. In this review we describe the empirical evidence for the neurodevelopmental model. First, by outlining the roots of psychological research that laid the foundation of the model. Thereafter, describing cognitive dysfunction observed in schizophrenia, and the course of cognitive functioning in the illness. Then, research findings that speak for and studies that speak against the view that schizophrenia is a degenerative process is discussed. We find that there is ample evidence that cognitive disturbance is a core element in schizophrenia. However, we have limited understanding of what initiates the abnormal development. This the paper ends with pointing out some of the factors that may trigger the deviant neurocognitive development in schizophrenia.
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Affiliation(s)
- Bjorn Rishovd Rund
- Department of Psychology, University of Oslo, Oslo, Norway.,Vestre Viken Hospital Trust, Drammen, Norway
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14
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Bechi M, Spangaro M, Agostoni G, Bosinelli F, Buonocore M, Bianchi L, Cocchi F, Guglielmino C, Bosia M, Cavallaro R. Intellectual and cognitive profiles in patients affected by schizophrenia. J Neuropsychol 2018; 13:589-602. [DOI: 10.1111/jnp.12161] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 04/30/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Margherita Bechi
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
| | - Marco Spangaro
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
| | | | | | - Mariachiara Buonocore
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
| | - Laura Bianchi
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
| | - Federica Cocchi
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
| | - Carmelo Guglielmino
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
| | - Marta Bosia
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
- Vita‐Salute San Raffaele University Milan Italy
| | - Roberto Cavallaro
- Department of Clinical Neurosciences IRCCS San Raffaele Scientific Institute Milan Italy
- Vita‐Salute San Raffaele University Milan Italy
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Hochberger W, Combs T, Reilly J, Bishop J, Keefe R, Clementz B, Keshavan M, Pearlson G, Tamminga C, Hill SK, Sweeney J. Deviation from expected cognitive ability across psychotic disorders. Schizophr Res 2018; 192:300-307. [PMID: 28545944 PMCID: PMC5699979 DOI: 10.1016/j.schres.2017.05.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/10/2017] [Accepted: 05/15/2017] [Indexed: 11/26/2022]
Abstract
Patients with schizophrenia show a deficit in cognitive ability compared to estimated premorbid and familial intellectual abilities. However, the degree to which this pattern holds across psychotic disorders and is familial is unclear. The present study examined deviation from expected cognitive level in schizophrenia, schizoaffective disorder, and psychotic bipolar disorder probands and their first-degree relatives. Using a norm-based regression approach, parental education and WRAT-IV Reading scores (both significant predictors of cognitive level in the healthy control group) were used to predict global neuropsychological function as measured by the composite score from the Brief Assessment of Cognition in Schizophrenia (BACS) test in probands and relatives. When compared to healthy control group, psychotic probands showed a significant gap between observed and predicted BACS composite scores and a greater likelihood of robust cognitive decline. This effect was not seen in unaffected relatives. While BACS and WRAT-IV Reading scores were themselves highly familial, the decline in cognitive function from expectation had lower estimates of familiality. Thus, illness-related factors such as epigenetic, treatment, or pathophysiological factors may be important causes of illness related decline in cognitive abilities across psychotic disorders. This is consistent with the markedly greater level of cognitive impairment seen in affected individuals compared to their unaffected family members.
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Affiliation(s)
- W.C. Hochberger
- Rosalind Franklin University of Medicine and Science, Department of Psychology
| | - T. Combs
- Rosalind Franklin University of Medicine and Science, Department of Psychology
| | - J.L. Reilly
- Northwestern University, Department of Psychiatry and Behavioral Sciences
| | - J.R. Bishop
- University of Minnesota, Department of Experimental and Clinical Pharmacology and Department of Psychiatry
| | - R.S.E. Keefe
- Duke University, Departments of Psychiatry, Neuroscience, and Psychology
| | | | | | - G.D. Pearlson
- Yale University School of Medicine, Department of Psychiatry
| | - C.A. Tamminga
- UT Southwestern Medical Center, Department of Psychiatry
| | - S. K. Hill
- Rosalind Franklin University of Medicine and Science, Department of Psychology,Corresponding author at: Rosalind Franklin University of Medicine and Science, Department of Psychology, 3333 Green Bay Rd., North Chicago, IL 60064, , Phone: (847) 578-8748
| | - J.A. Sweeney
- University of Cincinnati, Department of Psychiatry and Behavioral Neuroscience
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16
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Steen NE, Aas M, Simonsen C, Dieset I, Tesli M, Nerhus M, Gardsjord E, Mørch R, Agartz I, Melle I, Vaskinn A, Spigset O, Andreassen OA. Serum concentrations of mood stabilizers are associated with memory, but not other cognitive domains in psychosis spectrum disorders; explorative analyses in a naturalistic setting. Int J Bipolar Disord 2016; 4:24. [PMID: 27858347 PMCID: PMC5145893 DOI: 10.1186/s40345-016-0067-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 11/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mood stabilizers like lithium and anticonvulsants are used in bipolar and related psychotic disorders. There is a lack of knowledge of the relationship of these medications and cognition in the psychosis spectrum. We studied the association between serum concentration of mood stabilizers and cognitive performance in a well-characterized sample of bipolar and schizophrenia spectrum disorders. METHODS Serum concentrations of valproate, lamotrigine, and lithium were analyzed for associations to performance on neuropsychological tests in six cognitive domains in individuals with bipolar disorder (n = 167) and in a combined sample of individuals with bipolar or schizophrenia spectrum disorders (n = 217). Linear regression with adjustments for gender, age, and symptom levels of depression, mania, and psychosis were applied for the association analyses. RESULTS There were negative associations between serum levels of valproate and short term delayed recall (bipolar: p = 0.043; combined: p = 0.044) and working memory (bipolar: p = 0.043). A positive association was suggested between serum level of lithium and working memory (bipolar: p = 0.039). There were no other significant relationships between serum levels of valproate, lamotrigine, or lithium and neuropsychological test performance in neither the bipolar disorder nor the combined group. CONCLUSIONS Serum levels of mood stabilizers were unrelated to cognitive performance in most domains, indicating that higher dose does not lead to broader cognitive impairments in bipolar and related psychotic disorder patients. However, worsened memory with increasing levels of valproate suggests cautious dosing of anticonvulsants, while increasing lithium level seems to be associated with improved memory. The findings should be interpreted with caution due to the explorative, naturalistic design.
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Affiliation(s)
- Nils Eiel Steen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway. .,Drammen District Psychiatric Center, Clinic of Mental Health and Addiction, Vestre Viken Hospital Trust, 3004, Drammen, Norway.
| | - Monica Aas
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Carmen Simonsen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Dieset
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Martin Tesli
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Lovisenberg Diakonale Hospital, Oslo, Norway
| | - Mari Nerhus
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erlend Gardsjord
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ragni Mørch
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingrid Melle
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anja Vaskinn
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Olav Spigset
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway.,Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Heinrichs RW, Pinnock F, Muharib E, Hartman L, Goldberg J, McDermid Vaz S. Neurocognitive normality in schizophrenia revisited. SCHIZOPHRENIA RESEARCH-COGNITION 2015; 2:227-232. [PMID: 29114464 PMCID: PMC5609644 DOI: 10.1016/j.scog.2015.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 09/14/2015] [Accepted: 09/21/2015] [Indexed: 12/11/2022]
Abstract
The validity and significance of normal range neurocognition in schizophrenia remain unclear and controversial. We assessed whether normal range patients and controls demonstrate evidence of decline relative to premorbid ability and differ in performance profiles across measures, including those external to the normality criterion. In addition, we compared below normal range healthy control participants with patients at the same ability level. Performance normality was defined as a MATRICS Consensus Cognitive Battery (MCCB) composite T score between 40 and 60. Patients (n = 17) and controls (n = 24) meeting the criterion were compared on MCCB domain scores and on independent measures of reading ability, probabilistic and social reasoning. Patients (n = 19) and controls (n = 20) scoring below 40 on the MCCB composite were compared on the same set of measures. Cognitively normal range patients and controls did not differ on estimated premorbid ability or decline and differed only on the Processing Speed domain of the MCCB. Performance did not differ across other domains or on social and probabilistic reasoning tasks. Cognitively below normal range patients and controls showed marked discrepancies between premorbid and current ability, but there were no group differences. In addition, below normal range groups did not differ on any MCCB domain score or in terms of external cognitive measures. Cognitively normal range schizophrenia patients may be largely indistinguishable from normal range controls, with the exception of processing speed performance. More typical schizophrenia patients below the normal range may be indistinguishable from low-performing controls even in terms of processing speed.
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18
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Vaskinn A, Hartberg CB, Sundet K, Westlye LT, Andreassen OA, Melle I, Agartz I. To the editors: Reply to Anna R. Docherty. Psychiatry Res 2015; 233:497. [PMID: 26319295 DOI: 10.1016/j.pscychresns.2015.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 07/26/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Anja Vaskinn
- Department of Psychology, University of Oslo, Norway; NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway.
| | - Cecilie B Hartberg
- NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital Oslo, Norway
| | - Kjetil Sundet
- Department of Psychology, University of Oslo, Norway; NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Norway; NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway
| | - Ole A Andreassen
- NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway; Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
| | - Ingrid Melle
- NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway; Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
| | - Ingrid Agartz
- NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital Oslo, Norway; Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
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19
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Vaskinn A, Hartberg CB, Sundet K, Westlye LT, Andreassen OA, Melle I, Agartz I. Brain structure characteristics in intellectually superior schizophrenia. Psychiatry Res 2015; 232:123-9. [PMID: 25754688 DOI: 10.1016/j.pscychresns.2015.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 02/02/2015] [Accepted: 02/12/2015] [Indexed: 02/05/2023]
Abstract
The current study aims to fill a gap in the knowledge base by investigating the structural brain characteristics of individuals with schizophrenia and superior intellectual abilities. Subcortical volumes, cortical thickness and cortical surface area were examined in intellectually normal and intellectually superior participants with schizophrenia and their IQ-matched healthy controls, as well as in intellectually low schizophrenia participants. We replicated significant diagnostic group effects on hippocampal and ventricular size after correction for multiple comparisons. There were no statistically significant effects of intellectual level or of the interaction between diagnostic group and intellectual level. Effect sizes indicated that differences between schizophrenia and healthy control participants were of similar magnitude at both intellectual levels for all three types of morphological data. A secondary analysis within the schizophrenia group, including participants with low intellectual abilities, yielded numerical, but no statistically significant differences on any structural brain measure. The present findings indicate that the brain structure abnormalities in schizophrenia are present at all intellectual levels, and individuals with schizophrenia and superior intellectual abilities have brain structure abnormalities of the same magnitude as individuals with schizophrenia and normal intellectual abilities.
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Affiliation(s)
- Anja Vaskinn
- Department of Psychology, University of Oslo, Norway; NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway.
| | - Cecilie B Hartberg
- NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital Oslo, Norway
| | - Kjetil Sundet
- Department of Psychology, University of Oslo, Norway; NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Norway; NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway
| | - Ole A Andreassen
- NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway; Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
| | - Ingrid Melle
- NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway; Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
| | - Ingrid Agartz
- NORMENT K.G. Jebsen Centre for Psychosis Research, Oslo University Hospital, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital Oslo, Norway; Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
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Lystad JU, Falkum E, Mohn C, Haaland VØ, Bull H, Evensen S, Rund BR, Ueland T. The MATRICS Consensus Cognitive Battery (MCCB): performance and functional correlates. Psychiatry Res 2014; 220:1094-101. [PMID: 25242432 DOI: 10.1016/j.psychres.2014.08.060] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 08/27/2014] [Accepted: 08/29/2014] [Indexed: 02/01/2023]
Abstract
Neurocognitive impairment is a core feature in psychotic disorders and the MATRICS Consensus Cognitive Battery (MCCB) is now widely used to assess neurocognition in this group. The MATRICS has been translated into several languages, including Norwegian; although this version has yet to be investigated in an adult clinical population. Further, the relationship between the MATRICS and different measures of functioning needs examination. The purpose of this study was to describe neurocognition assessed with the Norwegian version of the MATRICS battery in a sample of patients with psychotic disorders compared to age and gender matched healthy controls and to examine the association with educational-, occupational- and social-functioning in the patient group. One hundred and thirty one patients and 137 healthy controls completed the battery. The Norwegian version of the MATRICS was sensitive to the magnitude of neurocognitive impairments in patients with psychotic disorders, with patients displaying significant impairments on all domains relative to healthy controls. Neurocognition was also related to both self-rated and objective functional measures such as social functioning, educational- and employment-history.
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Affiliation(s)
- June Ullevoldsæter Lystad
- Division of Mental Health and Addiction, Oslo University Hospital, Bygg 12, Gaustad Sykehus, PO Box 4956, Nydalen, 0424 Oslo, Norway.
| | - Erik Falkum
- Division of Mental Health and Addiction, Oslo University Hospital, Bygg 12, Gaustad Sykehus, PO Box 4956, Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Norway
| | - Christine Mohn
- Department of Research, Vestre Viken Hospital Trust, Drammen, Norway
| | - Vegard Øksendal Haaland
- Department of Psychology, University of Oslo, Norway; Department of Psychiatry, Sørlandet Hospital Trust, Kristiansand, Norway
| | - Helen Bull
- Division of Mental Health and Addiction, Oslo University Hospital, Bygg 12, Gaustad Sykehus, PO Box 4956, Nydalen, 0424 Oslo, Norway
| | - Stig Evensen
- Division of Mental Health and Addiction, Oslo University Hospital, Bygg 12, Gaustad Sykehus, PO Box 4956, Nydalen, 0424 Oslo, Norway
| | - Bjørn Rishovd Rund
- Department of Psychology, University of Oslo, Norway; Department of Research, Vestre Viken Hospital Trust, Drammen, Norway
| | - Torill Ueland
- Division of Mental Health and Addiction, Oslo University Hospital, Bygg 12, Gaustad Sykehus, PO Box 4956, Nydalen, 0424 Oslo, Norway
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