Neurocognitive Deficits and Functional Outcome in Schizophrenia: Are We Measuring the "Right Stuff"?

Green, Michael Foster; Kern, Robert S.; Braff, David L.; Mintz, Jim

doi:10.1093/oxfordjournals.schbul.a033430

Cited by 2,733 publications

(1,873 citation statements)

References 54 publications

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“…Cognition has been established as a predictor of realworld community functioning in schizophrenia (Green et al, 2000;Evans et al, 2003) and 69% of our sample of psychotic cannabis users reported a social use of cannabis, a similar proportion as in controls. Thus, our findings are compatible with the view that, among psychotic patients, the better premorbid cognition of the group who had smoked cannabis is likely to have facilitated their use of the drug in a normal recreational way, sharing it with their friends.…”

Section: Why Is Lifetime Cannabis Use Associated With Better Premorbimentioning

confidence: 67%

Cannabis users have higher premorbid IQ than other patients with first onset psychosis

Ferraro

Russo

O’Connor

et al. 2013

Schizophrenia Research

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a b s t r a c t a r t i c l e i n f oBackground: A number of studies have reported that patients with psychosis who use cannabis have better cognitive performance than those who do not. This is surprising as cannabis can impair cognition in healthy subjects. An obvious question is whether the better current performance of psychotic patients who have used cannabis is a reflection of their having a higher premorbid IQ than those psychotic patients who haven't used cannabis. Aim: In a sample of patients at their first episode of psychosis, we tested the hypothesis that patients who smoked cannabis would have a higher premorbid IQ than patients who did not. Methodology: 279 participants (119 patients and 160 healthy controls) were assessed in order to obtain current and premorbid IQ measures and detailed information on cannabis use. We examined the association between cannabis use and both premorbid and current IQ in patients and controls. Results: Patients who had ever smoked cannabis had significantly higher current (p b .001) and premorbid IQ (p = .004) compared to patients who had never used cannabis. This difference was not found among controls. Conclusions: These findings suggest that the better cognitive performance of patients with their first episode of psychosis who have used cannabis compared with those who haven't is due to the better premorbid IQ of the former.

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Section: Why Is Lifetime Cannabis Use Associated With Better Premorbimentioning

confidence: 67%

Cannabis users have higher premorbid IQ than other patients with first onset psychosis

Ferraro

Russo

O’Connor

et al. 2013

Schizophrenia Research

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“…Cognitive abilities are associated with functional capacity and community outcomes (Evans et al, 2003;Twamley et al, 2002;Patterson et al, 2001;Green and Nuechterlein, 1999;Green, 1996;Green et al, 2000), and may also affect life satisfaction. Poorer cognitive performance and self-reported functional status (e.g., unmarried, lower social functioning, smaller social support network) are correlated with lower subjective QOL (Corrigan and Buican, 1995;Norman et al, 2000;Lehman et al, 1983a).…”

Section: Predictors Of Subjective Qolmentioning

confidence: 99%

“…A global neuropsychological Z-score was calculated from mean Z-scores in four cognitive domains that are impaired in schizophrenia and are related to community functioning outcomes (Green et al, 2000;Heaton et al, 1994;Heinrichs and Zakzanis, 1998): Information processing speed (Trail Making Test, Part A [Reitan and Wolfson, 1993], WAIS-III Symbol Search and Digit Symbol subtests [Wechsler, 1997a]); Working memory (WAIS-III Letter Number Sequencing and Digit Span Backward subtests [Wechsler, 1997a]); Learning (Learning scores from the Hopkins Verbal Learning Test-Revised [Benedict et al, 1998], WMS-III Logical Memory [Wechsler, 1997b], and Brief Visuospatial Memory Test-Revised [Benedict, 1997]); and Executive functioning (Trail Making Test, Part B minus Part A [Reitan and Wolfson, 1993], Wisconsin Card Sorting Test-64 card version [Kongs et al, 2000], Stroop Color-Word Interference Test interference measure [Golden, 1978], Letter Fluency [Benton and Hamsher, 1989]). Lehman, 1988) assessed QOL within the past week globally and within eight domains: living situation, daily activities and functioning, family relations, social relations, finances, work and school, legal and safety issues, and health.…”

Section: Neuropsychological Test Battery-premorbid Verbal Intellectuamentioning

confidence: 99%

Subjective and objective quality of life in schizophrenia

Narvaez¹,

Twamley²,

McKibbin³

et al. 2008

Schizophrenia Research

226

139

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Objective-Quality of life (QOL) is considered an important outcome in the treatment of schizophrenia, but the determinants of QOL are poorly understood in this population. Furthermore, previous studies have relied on combined measures of subjective QOL (usually defined as life satisfaction) and objective QOL (usually defined as participation in activities and relationships). We examined separately the clinical, functional, and cognitive predictors of subjective and objective QOL in outpatients with schizophrenia. We hypothesized that better subjective QOL would be associated with less severe negative and depressive symptoms, better objective QOL, and greater everyday functioning capacity, and that better objective QOL would be associated with less severe negative and depressive symptoms, better cognitive performance, and greater functional capacity.Method-Participants included 88 outpatients with schizophrenia or schizoaffective disorder who completed a comprehensive series of assessments, including measures of positive, negative, and depressive symptoms; performance-based functional skills; a neuropsychological battery; and an interview measure of subjective and objective QOL.Results-In the context of multiple predictor variables, more severe depressive symptoms and better neuropsychological functioning were independent predictors of worse subjective QOL. More severe negative symptoms predicted worse objective QOL. Functional capacity variables were not associated with subjective or objective QOL.Conclusion-Treatments to improve QOL in schizophrenia should focus on negative symptoms and depressive symptoms.

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“…However, Kraepelin's characterization of schizophrenia from over a century ago included descriptions of cognitive deficits (Kraepelin, 1904), and these have gained greater attention in the treatment literature during the past decade (Green et al, 2000;Weinberger and Gallhofer, 1997). Cognitive deficits found in patients with schizophrenia appear widespread and are related to executive function, working memory, and attention.…”

Section: Introductionmentioning

confidence: 99%

Reversal of Subchronic PCP-Induced Deficits in Attentional Set Shifting in Rats by Sertindole and a 5-HT6 Receptor Antagonist: Comparison Among Antipsychotics

Rodefer

Nguyen

Karlsson

et al. 2007

Neuropsychopharmacol

116

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Currently accepted treatments for schizophrenia can effectively control positive symptoms but have limited impact on cognitive deficits in schizophrenia. The purpose of these experiments was to address this unmet need by characterizing the effects of classical and secondgeneration antipsychotics on cognitive impairments associated with schizophrenia. An additional aim was to characterize the part(s) of the pharmacological profile of drugs that were important to reverse deficits. Cognitive deficits were assessed using a frontally mediated attentional set-shifting task in rats that is analogous to tasks used in humans and nonhuman primates that assess executive function. Mirroring findings in patients with schizophrenia, the classical antipsychotic haloperidol was ineffective in treating set-shifting deficits induced by subchronic treatment with phencyclidine (PCP). Similarly, second-generation antipsychotics, risperidone, clozapine, and olanzapine were ineffective. In contrast, selected doses of sertindole and the 5-HT 6 receptor antagonist SB 271046 attenuated PCPinduced set-shifting deficits. Finally, the 5-HT 2A receptor antagonist M100907 was without effect. Further examination revealed that repeated treatment (21 days) with sertindole, but not olanzapine, also was effective in reversing the executive function deficit. These data suggest that the combination of 5-HT 6 antagonistic activity and the absence of antimuscarinic activity may represent key characteristics of the pharmacological profile for improved antipsychotic drugs for schizophrenia.

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Neurocognitive Deficits and Functional Outcome in Schizophrenia: Are We Measuring the "Right Stuff"?

Cited by 2,733 publications

References 54 publications

Cannabis users have higher premorbid IQ than other patients with first onset psychosis

Cannabis users have higher premorbid IQ than other patients with first onset psychosis

Subjective and objective quality of life in schizophrenia

Reversal of Subchronic PCP-Induced Deficits in Attentional Set Shifting in Rats by Sertindole and a 5-HT6 Receptor Antagonist: Comparison Among Antipsychotics

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