Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-26T08:58:52.208Z Has data issue: false hasContentIssue false
  • English
  • Français

Community Outcome in Cognitively Normal Schizophrenia Patients

Published online by Cambridge University Press:  01 August 2014

Eva Muharib ,
R. Walter Heinrichs ,
Ashley Miles ,
Farena Pinnock ,
Stephanie McDermid Vaz  and
Narmeen Ammari
Eva Muharib*
Affiliation:
York University, Toronto, Ontario, Canada
R. Walter Heinrichs
Affiliation:
York University, Toronto, Ontario, Canada
Ashley Miles
Affiliation:
York University, Toronto, Ontario, Canada
Farena Pinnock
Affiliation:
York University, Toronto, Ontario, Canada
Stephanie McDermid Vaz
Affiliation:
Cleghorn Early Intervention in Psychosis Program, Hamilton, Ontario, Canada St. Joseph’s Healthcare, Hamilton, Ontario, Canada & McMaster University, Hamilton, Ontario, Canada
Narmeen Ammari
Affiliation:
York University, Toronto, Ontario, Canada
*
Correspondence and reprint requests to: Eva Muharib, Department of Psychology, York University, 4700 Keele Street, Toronto, Ontario, Canada M3J 1P3. E-mail: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Recent reports suggest that cognition is relatively preserved in some schizophrenia patients. However, little is known about the functional advantage these patients may demonstrate. The purpose of this study was to identify cognitively normal patients with a recently developed test battery and to determine the functional benefit of this normality relative to cognitively impaired patients. Average-range cognitive ability was defined by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) composite score (T≥40) and applied to 100 patients with schizophrenia or schizoaffective disorder and to 81 non-psychiatric research participants. With group assignment adjusted for demographic variables, this procedure yielded 14 cognitively normal patients, 21 cognitively impaired patients, and 21 healthy adults with normal-range MCCB scores. Cognitively normal patients were indistinguishable from controls across all MCCB scales. Furthermore, their performance was superior to impaired patients on all scales except Social Cognition. Cognitively normal patients were also superior to impaired patients on a summary index of simulated life skills and functional competence. Nevertheless, both patient groups were equally disadvantaged relative to controls in independent community living. These findings suggest that normal-range cognition exists in schizophrenia, but fails to translate into enhanced community outcome. (JINS, 2014, 20, 1–7)

Keywords

Schizophrenia and disorders with psychotic featuresCognition disordersOutpatientsNeuropsychological testsActivities of daily living
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 20 , Issue 8 , September 2014 , pp. 805 - 811
Copyright
Copyright © The International Neuropsychological Society 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albert, N., Bertelsen, M., Thorup, A., Petersen, L., Jeppesen, P., Le Quack, P., Nordentoft, M. (2011). Predictors of recovery from psychosis analyses of clinical and social factors associated with recovery among patients with first-episode psychosis after 5 years. Schizophrenia Research, 125, 257–266.Google Scholar
Ammari, N., Heinrichs, R.W., & Miles, A.A. (2010). An investigation of 3 neurocognitive subtypes in schizophrenia. Schizophrenia Research, 121, 32–38.CrossRefGoogle ScholarPubMed
August, S.M., Kiwanuka, J.N., McMahon, R.P., & Gold, J.M. (2012). The MATRICS Consensus Battery (MCCB): Clinical and cognitive correlates. Schizophrenia Research, 134, 76–82.Google Scholar
Bowie, C.R., & Harvey, P.D. (2006). Cognitive deficits and functional outcome in schizophrenia. Journal of Neuropsychiatric Disease and Treatment, 2, 531–536.Google Scholar
Bowie, C.R., McGurk, S.R., Mausbach, B., Patterson, T.L., & Harvey, P.D. (2012). Combined cognitive remediation and functional skills training for schizophrenia: Effects on cognition, functional competence, and real-world behavior. American Journal of Psychiatry, 169, 10–18.CrossRefGoogle ScholarPubMed
Bowie, C.R., Reichenberg, A., Patterson, T.L., Heaton, R.K., & Harvey, P.D. (2006). Determinants of real-world functional performance in schizophrenia subjects: Correlations with cognition, functional capacity, and symptoms. American Journal of Psychiatry, 163, 418–425.Google Scholar
Bowie, C.R., Twamley, E.W., Anderson, H., Halpern, B., Patterson, T.L., & Harvey, P.D. (2007). Self-assessment of functional status in schizophrenia. Journal of Psychiatric Research, 41, 1012–1018.Google Scholar
Bromley, E., Mikesell, L., Mates, A., Smith, M., & Brekke, J.S. (2012). A video ethnography approach to assessing the ecological validity of neurocognitive and functional measures in severe mental illness: Results from a feasibility study. Schizophrenia Bulletin, 38, 981–991.CrossRefGoogle ScholarPubMed
Dickinson, D., Ramsey, M.E., & Gold, J.M. (2007). Overlooking the obvious: A meta-analytic comparison of digit symbol coding tasks and other cognitive measures in schizophrenia. Archives of General Psychiatry, 64(5), 532–542.Google Scholar
Dickinson, D., Tenhula, W., Morris, S., Brown, C., Peer, J., Spencer, K., Bellack, A.S. (2010). A randomized, controlled trial of computer-assisted cognitive remediation for schizophrenia. The American Journal of Psychiatry, 167, 170–180.CrossRefGoogle ScholarPubMed
Eack, S.M., Greeno, C.G., Pogue-Geile, M.F., Newhill, C.E., Hogarty, G.E., & Keshavan, M.S. (2010). Assessing social-cognitive deficits in schizophrenia with the Mayer-Salovey-Caruso Emotional Intelligence Test. Schizophrenia Bulletin, 36(2), 370–380.Google Scholar
Fett, A.K., Viechtbauer, W., Dominguez, M.D., Penn, D.L., van Os, J., & Krabbendam, L. (2011). The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: A meta-analysis. Neuroscience and Biobehavioral Reviews, 35(3), 573–588.Google Scholar
First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B. (1996). Structured clinical interview for DSM-IV axis I disorders: Non-patient edition (SCID-I/NP). New York: New York.Google Scholar
Green, M.F., Kern, R.S., Braff, D.L., & Mintz, J. (2000). Neurocognitive deficits and functional outcome in schizophrenia: Are we measuring the “right stuff”? Schizophrenia Bulletin, 26(1), 119–136.Google Scholar
Harvey, P.D., Keefe, R.S., Patterson, T.L., Heaton, R.K., & Bowie, C.R. (2009). Abbreviated neuropsychological assessment in schizophrenia: Prediction of different aspects of outcome. Journal of Clinical and Experimental Neuropsychology, 31, 462–471.Google Scholar
Heinrichs, R.W. (2005). The primacy of cognition in schizophrenia. American Psychologist, 60(3), 229–242.CrossRefGoogle ScholarPubMed
Heinrichs, R.W., Miles, A., Smith, D., Zargarian, T., McDermid Vaz, S., Goldberg, J.O., &Ammari, N. (2008). Cognitive, clinical, and functional characteristics of verbally superior schizophrenia patients. Neuropsychology, 22(3), 321–328.Google Scholar
Heinrichs, R.W., & Zakzanis, K.K. (1998). Neurocognitive deficit in schizophrenia: A quantitative review of the evidence. Neuropsychology, 12, 426–445.Google Scholar
Jaeger, J., Berns, S.M., & Czobor, P. (2003). The multidimensional scale of independent functioning: A new instrument for measuring functional disability in psychiatric populations. Schizophrenia Bulletin, 29(1), 153–167.Google Scholar
Kern, R.S., Nuechterlein, K.H., Green, M.F., Baade, L.E., Fenton, W.S., Gold, J.M., Marder, S.R. (2008). The MATRICS Consensus Cognitive Battery, Part 2: Co-norming and standardization. The American Journal of Psychiatry, 165, 214–220.Google Scholar
Kern, R.S., Gold, J.M., Dickinson, D., Green, M.F., Nuechterlein, K.H., Baade, L.E., Marder, S.R. (2011). The MCCB impairment profile for schizophrenia outpatients: Results from the MATRICS psychometric and standardization study. Schizophrenia Research, 126, 124–131.Google Scholar
Kremen, W.S., Seidman, L.J., Faraone, S.V., Toomey, R., & Tsuang, M.T. (2000). The paradox of normal neuropsychological function in schizophrenia. Journal of Abnormal Psychology, 109(4), 743–752.CrossRefGoogle ScholarPubMed
Kremen, W.S., Seidman, L.J., Faraone, S.V., & Tsuang, M.T. (2001). Intelligence quotient and neuropsychological profiles in patients with schizophrenia and normal volunteers. Society of Biological Psychiatry, 50, 453–462.Google Scholar
Leung, W.W., Bowie, C.R., & Harvey, P.D. (2008). Functional implications of neuropsychological normality and symptom remission in older outpatients diagnosed with schizophrenia: A cross-sectional study. Journal of International Neuropsychological Society, 14, 479–488.Google Scholar
MacCabe, J.H., Brebion, G., Reichenberg, A., Ganguly, T., McKenna, P.J., Murray, R.M., & David, A.S. (2012). Superior intellectual ability in schizophrenia: Neuropsychological characteristics. Neuropsychology, 26(2), 181–190.CrossRefGoogle ScholarPubMed
McKibbin, C.L., Brekke, J.S., Sires, D., Jeste, D.V., & Thomas, L.P. (2004). Direct assessment of functional abilities: Relevance to persons with schizophrenia. Schizophrenia Research, 72, 53–67.CrossRefGoogle ScholarPubMed
Nuechterlein, K.H., Green, M.F., Kern, R.S., Baade, L.E., Barch, D.M., Cohen, J.D., Marder, S.R. (2008). The MATRICS Consensus Cognitive Battery, part 1: Test selection, reliability, and validity. The American Journal of Psychiatry, 165(2), 203–213.Google Scholar
Opler, L.A., Kay, S.R., Lindenmayer, J.P., & Fiszbein, A. (1999). Structured clinical interview: The Positive and Negative Syndrome Scale (SCI-PANSS). North Tonawanda, NY: Multi-Health Systems Inc.Google Scholar
Palmer, B.W., Keaton, R.K., Paulsen, J.S., Kuck, J., Braff, D., Harris, M.J., Jeste, D.V. (1997). Is it possible to be schizophrenic yet neuropsychologically normal? Neuropsychology, 11(3), 437–446.Google Scholar
Patterson, T.L., Goldman, S., McKibbin, C.L., Hughs, T., & Jeste, D.V. (2001). UCSD performance-based skills assessment: Development of a new measure of everyday functioning for severely mentally ill adults. Schizophrenia Bulletin, 27(2), 235–245.Google Scholar
Psychological Corporation. (1999). Wechsler Abbreviated Scale of Intelligence (WASI) manual. San Antonio, TX: Psychological Corporation.Google Scholar
Schmidt, S.J., Mueller, D.R., & Roder, V. (2011). Social cognition as a mediator variable between neurocognition and functional outcome in schizophrenia: Empirical review and new results by structural equation modeling. Schizophrenia Bulletin, 37(S2), 41–54.Google Scholar
Shamsi, S., Lau, A., Lencz, T., Burdick, K.E., DeRosse, P., Brenner, R., Malhotra, A.K. (2011). Cognitive and symptomatic predictors of functional disability in schizophrenia. Schizophrenia Research, 126(1–3), 257–264.Google Scholar
Silverstein, S.M., All, S.D., & Jaeger, J. (2011). Cognition-UPSA score relationships: A further analysis of Silverstein et al. (2010) data and some caveats. Psychiatry Research, 187(3), 424–431.CrossRefGoogle Scholar
Velligan, D.I., Mahurin, R.K., Diamond, P.L., Hazelton, B.C., Eckert, S.L., & Miller, A.L. (1997). The functional significance of symptomatology and cognitive function in schizophrenia. Schizophrenia Research, 25, 21–31.CrossRefGoogle ScholarPubMed
Weickert, T.W., Goldberg, T.E., Gold, J.M., Bigelow, L.B., Egan, M.F., & Weinberger, D.R. (2000). Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Archives of General Psychiatry, 57, 907–913.CrossRefGoogle ScholarPubMed
Wilkinson, G.S., & Robertson, G. (2006). WRAT-4: The Wide Range Achievement test administration manual (4th ed.). Wilmington, DE: Wide Range.Google Scholar