Stability and Course of Neuropsychological Deficits in Schizophrenia

Abstract

Neuropsychological impairment in ambulatory persons with schizophrenia appears to remain stable, regardless of baseline characteristics and changes in clinical state. Our results may not be generalizable to the minority of institutionalized poor-outcome patients.

Baseline Neurocognitive Deficits in the CATIE Schizophrenia Trial

“…Older patients may be particularly challenged to complete a 90-min test battery. These relations with age are in line with previous studies of patients with schizophrenia and healthy controls (Heaton et al, 2001).…”

“…As this study was limited by the absence of a healthy control group, the severity of neurocognitive impairment in the patients in the current study was determined by comparing their performance to that of healthy controls for tests that had adequate published normative samples. The magnitude of impairment was similar to estimates from meta-analyses (Heinrichs and Zakzanis, 1998), large clinical trials , and results obtained at academic research institutions (Keefe et al, 2004;Bilder et al, 2000;Heaton et al, 2001).…”

Neuropsychological substrates and everyday functioning implications of prospective memory impairment in schizophrenia

“…The cognitive impairments of schizophrenia are numerous and disabling (Elvevag and Goldberg, 2000;Green et al, 2004;Heaton et al, 2001;Twamley et al, 2002). Episodic learning and memory deficits are particularly common and involve higher-level encoding and retrieval difficulties in the context of intact retention of learned information (Aleman et al, 1999); functional neuroimaging studies implicate prefrontal systems dysfunction rather than temporal lobe dysfunction in the learning and memory deficits of schizophrenia (Seidman et al, 1994;Achim and LePage, 2005).…”

Context processing in schizotypal personality disorder: Evidence of specificity of impairment to the schizophrenia spectrum.

“…Individuals with schizophrenia demonstrate mild to moderate impairment across a broad range of neuropsychological abilities, with what appears to be more severe impairment in tasks related both to working and episodic memory and to executive functioning (Green, 2006;Mishara & Goldberg, 2004). Although these cognitive limitations in schizophrenia tend to be pervasive in nature, affecting many areas of neuropsychological functioning (Davidson et al, 1995;Heaton et al, 2001;Saykin et al, 1994), new research and theory suggest that working memory may be a core deficit that underlies some of the other cognitive impairments in schizophrenia (Cohen & Servan-Schreiber, 1992;Silver, Feldman, Bilker, & Gur, 2003), as well as other spectrum disorders, such as schizotypal personality disorder (SPD).SPD is a schizophrenia spectrum disorder closely linked with the symptom profile of schizophrenia (Siever, 1995). In addition to demonstrating characteristic clinical symptoms, SPD patients demonstrate cognitive impairment in several ability areas, such as executive functioning (Diforio, Walker, & Kestler, 2000), verbal learning and abstraction (Bergman et al, 1998;Voglmaier, Seidman, Salisbury, & McCarley, 1997), recognition memory (Cadenhead, Perry, Shafer, & Braff, 1999), visual perception and spatial working memory (Farmer et al, 2000;Park, Holzman, & Lenzenweger, 1995;Roitman et al, 2000), cognitive inhibition (Beech, Baylic, Smithson, & Claridge, 1989;Moritz & Mass, 1997), dual-task information processing (Harvey, Reichenberg, Romero, Granholm, & Siever, 2006;Moriarty, Harvey, Granholm, Mitropoulou, & Siever, 2003), and sustained attention (Roitman et al, 1997).…”