Journal of the Formosan Medical Association
Volume 105, Issue 12 , Pages 978-991, 2006

Patterns and Clinical Correlates of Neuropsychologic Deficits in Patients with Schizophrenia

  • Shi-Kai Liu

      Affiliations

    • Department of Psychiatry, National Taiwan University Hospital; Taipei, Taiwan
    • Department of Psychiatry, Far Eastern Memorial Hospital; Taipei, Taiwan
    • ,
  • Ming-Hsin Hsieh

      Affiliations

    • Department of Psychiatry, National Taiwan University Hospital; Taipei, Taiwan
    • ,
  • Tzung-Jeng Huang

      Affiliations

    • Department of Psychiatry, National Taiwan University Hospital; Taipei, Taiwan
    • Department of Psychiatry, National Taiwan University, Taipei, Taiwan
    • ,
  • Chi-Ming Liu

      Affiliations

    • Department of Psychiatry, National Taiwan University Hospital; Taipei, Taiwan
    • Department of Psychiatry, National Taiwan University, Taipei, Taiwan
    • ,
  • Cheng-Chung Liu

      Affiliations

    • Department of Psychiatry, National Taiwan University Hospital; Taipei, Taiwan
    • Department of Psychiatry, National Taiwan University, Taipei, Taiwan
    • ,
  • Mau-Sun Hua

      Affiliations

    • Department of Psychology, National Taiwan University, Taipei, Taiwan
    • ,
  • W.J. Chen

      Affiliations

    • Department of Psychiatry, National Taiwan University Hospital; Taipei, Taiwan
    • Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
    • ,
  • Hai-Gwo Hwu

      Affiliations

    • Department of Psychiatry, National Taiwan University Hospital; Taipei, Taiwan
    • Department of Psychiatry, National Taiwan University, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Professor Hai-Gwo Hwu, Department of Psychiatry, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan

Received 22 December 2005; received in revised form 24 February 2006; accepted 4 July 2006.

Article Outline

Background/purpose

Neuropsychologic deficits are prevalent among schizophrenic patients and are closely associated with pathogenesis and outcome. The pattern, extent, severity and contributing factors to such deficits remain to be examined in Taiwanese schizophrenic patients.

Methods

A total of 122 schizophrenic patients and 94 healthy subjects for comparison were assessed by a comprehensive neuropsychologic test battery covering the eight cognitive domains of verbal ability, visual spatial ability, abstraction/execution, verbal memory, visual memory, perceptual/motor ability, mental control and attention. The relationships among cognitive deficits, demographic characteristics, clinical historical variables and clinical symptoms were further explored by multivariate regression analysis.

Results

A pattern of selective deficits superimposed on a generalized deficit was found for schizophrenic patients as a group. The mean overall deficit was 1.93 standard deviations below the control mean, and abstraction/execution, verbal memory, visual memory and attention were relatively impaired among the eight cognitive domains. However, there was also marked heterogeneity in individual performances in that 24.2%, 46.2% and 29.5% of patients performed at within normal range, moderately impaired and severely impaired levels, respectively. Duration of illness substantially affected the profile and severity of the deficits, suggesting a progressive deteriorating course in neuropsychological performance. The major predictors of cognitive deficits were number of formal years of education achieved and concurrent severity of disorganization symptoms.

Conclusion

In a large sample of schizophrenic patients who underwent comprehensive neuropsycho-logic evaluation, the current results confirmed that cognitive deficits were prevalent but not a universal feature within schizophrenia. The selective impairment pattern also confirmed that such deficits were mainly in frontal and frontotemporal related functions. Despite evidence suggesting that disease chronic-ity entailed a decline in selective cognitive domains, the trajectory of the neuropsychologic deficits remains to be examined by further longitudinal studies.

Key Words:  disorganization symptom , duration of illness , neuropsychologic deficits , schizophrenia

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PII: S0929-6646(09)60282-5

doi:10.1016/S0929-6646(09)60282-5

Journal of the Formosan Medical Association
Volume 105, Issue 12 , Pages 978-991, 2006

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