Wisconsin Card Sorting Test scores and clinical and sociodemographic correlates in Schizophrenia: multiple logistic regression analysis

Abstract

ObjectivesThis study investigated what clinical and sociodemographic factors affected Wisconsin Card Sorting Test (WCST) factor scores of patients with schizophrenia to evaluate parameters or items of the WCST.DesignCross-sectional study.SettingPatients with schizophrenia from three hospitals participated.ParticipantsParticipants were recruited from July 2009 to August 2011. 131 Japanese patients with schizophrenia (84 men and 47 women, 43.5±13.8 years (mean±SD)) entered and completed the study. Participants were recruited in the study if they (1) met DSM-IV criteria for schizophrenia; (2) were physically healthy and (3) had no mood disorders, substance abuse, neurodevelopmental disorders, epilepsy or mental retardation. We examined their basic clinical and sociodemographic factors (sex, age, education years, age of onset, duration of illness, chlorpromazine equivalent doses and the positive and negative syndrome scale (PANSS) scores).Primary and secondary outcome measuresAll patients carried out the WCST Keio version. Five indicators were calculated, including categories achieved (CA), perseverative errors in Milner (PEM) and Nelson (PEN), total errors (TE) and difficulties of maintaining set (DMS). From the principal component analysis, we identified two factors (1 and 2). We assessed the relationship between these factor scores and clinical and sociodemographic factors, using multiple logistic regression analysis.ResultsFactor 1 was mainly composed of CA, PEM, PEN and TE. Factor 2 was mainly composed of DMS. The factor 1 score was affected by age, education years and the PANSS negative scale score. The factor 2 score was affected by duration of illness.ConclusionsAge, education years, PANSS negative scale score and duration of illness affected WCST factor scores in patients with schizophrenia. Using WCST factor scores may reduce the possibility of type I errors due to multiple comparisons.

Medial frontal gyrus alterations in schizophrenia: Relationship with duration of illness and executive dysfunction

“…CAT: HC ¼4 70.4, SCZr 10 years¼ 2.8 7 0.7, SCZ4 10 years¼ 1.7 7 0.8; PR: HC¼ 30.17 3.5, SCZr 10 years ¼36.1 77.6, SCZ410 years ¼66.8 7 10.8; PE: HC¼ 24.2 7 3, SCZ r 10 years¼ 38.5 7 6.9, SCZ410 years ¼45.9 7 11. our findings, we have additionally provided the effect sizes of our results, which were considered moderate to large. Finally, in contrast to other studies (Banno et al, 2012), our results failed to show an impact of cognitive impairment on severity of symptoms or on global functioning. This lack of association highlights the effect of DoI on GMV differences, which are not influenced by differences in symptoms or functioning.…”

“…We can speculate that these differences may be secondary to the different temporal subdivision within the patient groups compared with that in the present study (i.e., 10 years). Other studies found an effect of the duration of illness in determining the number of perseverative responses (Bellino et al, 2004) and the "difficulty to maintain set", another WCST performance measure (Banno et al, 2012). A meta-analysis (Johnson-Selfridge and Zalewski, 2001) of executive functioning in patients with schizophrenia did not uncover any significant effect for DoI on behavioral performance.…”

Association study of BCL9 gene polymorphism rs583583 with schizophrenia and negative symptoms in Japanese population

“…The WCST 28 mainly assesses executive function including cognitive flexibility in response to feedback. We used a modified and computerized version of the WCST, the (Keio Version) (KWCST) 29 30 31 . The outcome measures were the numbers of categories achieved (CA), total errors (TE), and perseverative errors of Milner (PEM) and Nelson types (PEN) in the first trial.…”

COMT and 5-HT1A-receptor genotypes potentially affect executive functions improvement after cognitive remediation in schizophrenia

“…Differences between COMT and 5-HT1A-R genotypes and WCST performances (number of perseverative errors) at baseline were analysed by means of analysis of covariance (ANCOVA), with age and number of years of education as covariates, since these variables were found to influence WCST performances in schizophrenia (Banno et al, 2012 ).…”