Neuropsychological Differences Between First-Admission Schizophrenia and Psychotic Affective Disorders

Mojtabai, Ramin; Bromet, Evelyn J.; Harvey, Philip D.; Carlson, Gabrielle A.; Craig, Thomas J.; Fennig, Shmuel

doi:10.1176/appi.ajp.157.9.1453

Cited by 108 publications

(92 citation statements)

References 44 publications

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“…In contrast, Hobart et al [42] have found a significant difference between both groups on the vocabulary subtest of the WAIS-III (p < 0.005), with a large effect size (d = 0.97), making this variable one of the most discriminating of all the variables studied. A similar result was found in patients experiencing their first psychotic episode, with bipolar patients being less impaired than schizophrenic patients on the vocabulary subtest of the WAIS-R [54]. …”

Section: Resultssupporting

confidence: 67%

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Specificity of Cognitive Deficits in Bipolar Disorder versus Schizophrenia

Daban

Martínez-Àran

Torrent

et al. 2006

Psychother Psychosom

184

138

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Background: More and more epidemiological, genetic and neuroimaging studies show similarities between bipolar disorder (BD) and schizophrenia (SZ). Cognitive functions are known to be highly impaired in SZ and are increasingly studied in BD. When both populations are compared, the conclusions appear to be contradictory. The purpose of this review is to help define the profile of cognitive deficits in BD and in SZ. Methods: A systematic review of the literature of neuropsychological studies comparing BD and SZ was made, beginning in January 1990 and ending in January 2005. Thirty-eight studies met the required quality criteria and were included in this review. Results: Bipolar patients exhibit extensive cognitive abnormalities with a pattern of deficits that is not unique to this disease. However, when compared to schizophrenic patients, bipolar patients demonstrate a lesser degree of deficits, particularly concerning premorbid and current intelligence quotient and perhaps attention, verbal memory and executive functions. When looking into effect sizes, there seem to be different profiles even in studies finding no significant differences. Conclusions: The neuropsychological differences reported between both groups could be due to the presence of psychotic features, to environmental factors (stressful events, duration of the disease and number of hospitalisations) and could also be related to differences during the neurodevelopmental phase. Further studies should confirm whether these results are truly related to different neurobiological backgrounds.

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Section: Resultssupporting

confidence: 67%

“…Ten studies have compared bipolar and schizophrenic patients while performing this test [42, 44, 46,50,51,52, 54, 65, 69, 70]. Six studies did not find any difference between the two groups [44, 46, 50, 51, 69, 70].…”

Section: Resultsmentioning

confidence: 99%

Specificity of Cognitive Deficits in Bipolar Disorder versus Schizophrenia

Daban

Martínez-Àran

Torrent

et al. 2006

Psychother Psychosom

184

138

View full text Add to dashboard Cite

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“…Both groups were compared with respect to executive functioning. Similar levels of cognitive impairment would be expected in mania and acute schizophrenia, since some overlapping has also been observed with respect to clinical symptomatology or neuroimaging findings in these states [4, 19, 24, 25], in spite of contradictions of several investigations [26, 27]. Nevertheless, less attention has been paid to the most extreme positions of the postulated common pathway between schizophrenia and bipolar disorder, such as remitted bipolar patients and negative schizophrenics.…”

Section: Methodsmentioning

confidence: 91%

Executive Function in Patients with Remitted Bipolar Disorder and Schizophrenia and Its Relationship with Functional Outcome

Martínez‐Arán

Penadés

Vieta

et al. 2001

Psychother Psychosom

167

121

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Background: Recent studies have reported that differences in cognitive performance between schizophrenic and bipolar patients seem to be smaller than expected. Patients with schizophrenia have consistently shown frontal executive dysfunctions, but studies regarding executive abilities in bipolar patients are scarce and discrepant. As executive function has been associated with psychosocial functioning in schizophrenia, we wanted to investigate if such a relationship is also present in bipolar disorder and the differences between the two groups. Methods: Executive function was assessed in 49 euthymic (at least 6 months in remission, Hamilton Depression Rating Scale ≤8 and Young Mania Rating Scale ≤6) bipolar and in 49 schizophrenic, residual-type (with at least 1 year without acute exacerbation and predominant negative symptomatology) patients, by the Wisconsin Card Sorting Test (WCST), FAS Test (COWAT) and Trail Making Test. Baseline clinical and psychosocial variables were controlled and psychopathology evaluated by means of the Positive and Negative Syndrome Scale (PANSS). Results: The two groups showed a similar pattern of cognitive deficits in tests of executive function, except for the number of categories achieved in the WCST, which was significantly lower in the schizophrenic group (F = 7.26; p = 0.009). Functional outcome was predicted by the negative syndrome (PANSSN) and perseverative errors (WCST) in schizophrenic patients, and general psychopathology (PANSSG) was the best predictor of functional outcome in the bipolar group. Conclusion: Executive function was a good predictor of functional outcome in the schizophrenic group, whereas clinical variables were more predictive of the bipolar one. Patterns of cognitive disturbances in tasks of executive function are similar in both groups but quantitatively more marked in schizophrenia.

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“…To date, only a few studies compared the cognitive functioning of these groups, and they have not provided any evidence for between-group cognitive differences. 19,62 The current study does not provide any information regarding longitudinal progression of cognitive deficits from early to chronic phases of illness. Only 6 of the studies included in the meta-analysis investigated cognitive impairment in FE patients with AP.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Impairment in Affective Psychoses: A Meta-analysis

Bora

Yücel

Pantelis

2009

Schizophrenia Bulletin

120

100

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It has recently been suggested that cognitive impairment should be included in the diagnostic criteria of schizophrenia. One of the main arguments in support of this suggestion has been the hope that cognitive impairment can help distinguish schizophrenia from bipolar disorder (BD). However, recent evidence shows that cognitive deficits occur in BD and persist beyond euthymia. Further, mood disorders with psychotic features might be expected to manifest greater cognitive impairment, which further complicates the potential to differentiate these disorders. The goal of the current meta-analysis was to examine the magnitude and characteristics of cognitive impairments in affective psychoses (AP). A systematic search of the existing literature sourced 27 studies that met the inclusion criteria. These studies compared cognitive performances of 763 patients with AP (550 BD and 213 major depressive disorder) and 1823 healthy controls. Meta-regression and subgroup analyses were used to examine the effects of moderator variables. Meta-analyses of these studies showed that patients with AP were impaired in all 15 cognitive tasks with large effect sizes for most measures. There were no significant differences between the magnitude of impairments between the BD and major depressive disorder groups. The largest effect size was found for symbol coding, stroop task, verbal learning, and category fluency, reflecting impairments in elementary and complex aspects of attentional processing, as well as learning and memory. In general, the pattern of cognitive impairments in AP was similar to reported findings in euthymic patients with BD, but relatively more pronounced.

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Neuropsychological Differences Between First-Admission Schizophrenia and Psychotic Affective Disorders

Abstract: Even early in its course, schizophrenia is distinguishable from psychotic affective disorders by global and specific neuropsychological deficits. These deficits might contribute to the disability and poor outcome associated with schizophrenia in the mid- and long-term course.

Cited by 108 publications

References 44 publications

Specificity of Cognitive Deficits in Bipolar Disorder versus Schizophrenia

Specificity of Cognitive Deficits in Bipolar Disorder versus Schizophrenia

Executive Function in Patients with Remitted Bipolar Disorder and Schizophrenia and Its Relationship with Functional Outcome

Cognitive Impairment in Affective Psychoses: A Meta-analysis

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