Cognitive heterogeneity in first-episode schizophrenia

Joyce, Eileen M.; Hutton, Sam; Mutsatsa, Stanley; Barnes, Thomas R. E.

doi:10.1192/bjp.187.6.516

Cited by 123 publications

(112 citation statements)

References 53 publications

(64 reference statements)

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“…As expected, in healthy controls, premorbid IQ estimated by the NART is usually very similar to current IQ (e.g. Joyce et al, 2005) as measured by tests such as the Wechsler Adult Intelligence Scale -Revised (WAIS-R; Wechsler, 1981), supporting the validity of the NART. The NART also probably gives a valid measure of premorbid IQ in most people with schizophrenia (Frith et al, 1991;Crawford et al, 1992).…”

Section: Simultaneous Estimate Of Premorbid and Current Intellectual mentioning

confidence: 77%

“…This is because a substantial proportion of people with established schizophrenia show no evidence of overall intellectual decline, especially in the early stages of the illness. Thus, more than half of a sample with first-episode schizophrenia showed no substantial IQ decline (Joyce et al, 2005), and in a sample with recently diagnosed schizophrenia (Johnstone et al, 2005), the mean values for premorbid and present IQ were almost identical, suggesting that most if not all individuals showed no substantial IQ decline. An additional limitation is that the NART may overestimate IQ decline in some people with schizophrenia and spuriously identify IQ decline in a small proportion of healthy people (Crawford et al, 1990;Russell et al, 2000).…”

Section: Simultaneous Estimate Of Premorbid and Current Intellectual mentioning

confidence: 99%

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IQ tests as aids to diagnosis and management in early schizophrenia

Harrison-Read

2008

Adv. psychiatr. treat

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Intellectual and other more specific neurocognitive impairments in schizophrenia are important for understanding the aetiology of the condition and its likely outcome. However, these impairments are not usually considered important for supporting a diagnosis in suspected early schizophrenia. IQ testing is widely available and probably acceptable to most people likely to be experiencing the early stages of psychosis and who might be unable or unwilling to disclose details of their history and mental state or to cooperate with more comprehensive neuropsychological assessment. Although in general IQ tests have only limited diagnostic value in schizophrenia, the finding of a substantial decline in IQ score from the estimated premorbid level may be helpful in supporting a provisional diagnosis of early schizophrenia in cases without organic signs in which the clinical picture is unclear or incomplete. More important, the results of IQ tests may contribute to a better understanding of patients' impairments and assist clinical management in a number of ways, as illustrated here by three fictional case studies.

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Section: Simultaneous Estimate Of Premorbid and Current Intellectual mentioning

confidence: 77%

Section: Simultaneous Estimate Of Premorbid and Current Intellectual mentioning

confidence: 99%

IQ tests as aids to diagnosis and management in early schizophrenia

Harrison-Read

2008

Adv. psychiatr. treat

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“…For Spatial Working Memory, the Executive Golf Task, a version of the Spatial Working Memory task (SWT) (Hutton et al, 1998;Joyce et al, 2005;Owen et al, 1996) was used that encompasses the distinction between maintenance and manipulation. This is a naturalistic version of the task with three dimensional graphics (Feigenbaum et al, 1996;Miotto et al, 1996), which has been used in schizophrenia (Kravariti et al, 2007;Toulopoulou et al, 2003Toulopoulou et al, , 2004.…”

Section: Working Memorymentioning

confidence: 99%

“…To study this issue, researchers have compared functioning in first episode and chronic schizophrenia across different domains. First episode schizophrenia shows executive dysfunction at this early stage, with some degree of clinical heterogeneity (Chan et al, 2006b;Joyce et al, 2005;Joyce & Roiser, 2007), but less impairment than is found in chronic schizophrenia (Chan et al, 2006a;Saykin et al, 1994). Profiles have varied between studies, with parallel flat profiles of diffuse general impairment, parallel nonflat profiles with selective impairments, and selective impairments specific to chronic schizophrenia (Albus et al, 1996;Blanchard & Neale, 1994;Chan et al, 2006a,b;Saykin et al, 1994).…”

Section: Introductionmentioning

confidence: 99%

Executive functioning in schizophrenia and the relationship with symptom profile and chronicity

Greenwood¹,

Morris²,

Sigmundsson

et al. 2008

J Int Neuropsychol Soc

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This study reports the executive function profile in people with schizophrenia, with a simultaneous comparison of chronicity and of those with predominately disorganization versus psychomotor poverty symptoms. The patients were split into one set defined according to symptoms (29 with disorganization, 29 with negative symptoms) and the other representing chronicity (22 first-episode, 35 chronic) and compared with 28 healthy controls on a broad range of executive process measures. Differences were investigated in both the severity and profile of impairments. Impairment patterns interacted with symptom groups, with disorganization and psychomotor poverty symptom groups showing different profiles of executive impairment. In contrast, across these same executive processes, impairment profiles were similar between first episode and chronic schizophrenia and became more similar, particularly for working memory, when controlling for disorganization symptoms. The executive profile, therefore, is related to symptom type rather than chronicity. (JINS, 2008, 14, 782-792.)

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“…Consequently, it is not possible to evaluate the specific treatment effect that the programme had on a given cognitive function and, in particular, the specific role that each function may have played in improving schizophrenia patients' cognitive and social functioning. Second, some of these studies did not take into account the heterogeneity of cognitive deficits characterised in schizophrenia (e.g., Goldstein & Shemansky, 1995;Joyce, Hutton, Mutsatsa, & Barnes, 2005;Joyce & Roiser, 2007;Seaton, Goldstein, & Allan, 2001), as the same cognitive rehabilitation programme was administered to all the patients. For instance, in the case of working memory, two schizophrenia patients could show a completely different pattern of impairment, i.e., affecting differently the slave systems (phonological loop and visuospatial sketchpad) and/or the sub-processes of the central executive such as information manipulation, updating, and dual-task monitoring.…”

Section: Introductionmentioning

confidence: 99%

Cognitive rehabilitation of the updating sub-component of working memory in schizophrenia: A case study

Levaux

Vezzaro

Larøi

et al. 2009

Neuropsychological Rehabilitation

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Working memory problems have been identified as a core cognitive deficit in schizophrenia. In this paper, we present the results of a cognitive rehabilitation programme (Duval & Coyette, 2005) administered to a schizophrenia patient, and specifically designed to improve the updating sub-component of working memory. The original feature of this programme was that it involved two types of updating exercises: cognitive and ecological. The purpose was to enable the patient to acquire cognitive strategies that alleviate the mental load of the central executive and to transfer them to daily life. The specificity and efficacy of the programme were assessed with multiple (cognitive, ecological and non-target) baseline measurements. In addition, several questionnaires were administered to assess the effect of the programme on subjective cognitive complaints affecting daily life, psychiatric symptoms and self-esteem. The results demonstrated the efficacy of the rehabilitation programme on the updating function and the generalisation of these beneficial effects to daily life. A significant decrease in both subjective cognitive complaints and psychiatric symptoms was also observed. However, the patient's self-esteem did not improve.

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Cognitive heterogeneity in first-episode schizophrenia

Abstract: At illness onset, cognitive heterogeneity is present in people with schizophrenia, with a high proportion having undergone general cognitive decline. However, working memory impairment may be a common feature. Lower premorbid IQ is a risk factor for an earlier onset.

Cited by 123 publications

References 53 publications

IQ tests as aids to diagnosis and management in early schizophrenia

IQ tests as aids to diagnosis and management in early schizophrenia

Executive functioning in schizophrenia and the relationship with symptom profile and chronicity

Cognitive rehabilitation of the updating sub-component of working memory in schizophrenia: A case study

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