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Relationship of behavioural and symptomatic syndromes in schizophrenia to spatial working memory and attentional set-shifting ability

Published online by Cambridge University Press:  21 April 2004

C. PANTELIS ,
C. A. HARVEY ,
G. PLANT ,
E. FOSSEY ,
P. MARUFF ,
G. W. STUART ,
W. J. BREWER ,
H. E. NELSON ,
T. W. ROBBINS  and
T. R. E. BARNES
C. PANTELIS
Affiliation:
Melbourne Neuropsychiatry Centre, The University of Melbourne and Sunshine Hospital, Parkville and St. Albans, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia; ORYGEN Research Centre, The University of Melbourne, Parkville, Australia; North West Area Rehabilitation Services, NorthWestern Mental Health, Melbourne, Australia; La Trobe University, Melbourne, Australia; Imperial College Faculty of Medicine, Division of Neuroscience and Psychological Medicine, London, UK; Department of Experimental Psychology, Cambridge University, UK
C. A. HARVEY
Affiliation:
Melbourne Neuropsychiatry Centre, The University of Melbourne and Sunshine Hospital, Parkville and St. Albans, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia; ORYGEN Research Centre, The University of Melbourne, Parkville, Australia; North West Area Rehabilitation Services, NorthWestern Mental Health, Melbourne, Australia; La Trobe University, Melbourne, Australia; Imperial College Faculty of Medicine, Division of Neuroscience and Psychological Medicine, London, UK; Department of Experimental Psychology, Cambridge University, UK
G. PLANT
Affiliation:
Melbourne Neuropsychiatry Centre, The University of Melbourne and Sunshine Hospital, Parkville and St. Albans, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia; ORYGEN Research Centre, The University of Melbourne, Parkville, Australia; North West Area Rehabilitation Services, NorthWestern Mental Health, Melbourne, Australia; La Trobe University, Melbourne, Australia; Imperial College Faculty of Medicine, Division of Neuroscience and Psychological Medicine, London, UK; Department of Experimental Psychology, Cambridge University, UK
E. FOSSEY
Affiliation:
Melbourne Neuropsychiatry Centre, The University of Melbourne and Sunshine Hospital, Parkville and St. Albans, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia; ORYGEN Research Centre, The University of Melbourne, Parkville, Australia; North West Area Rehabilitation Services, NorthWestern Mental Health, Melbourne, Australia; La Trobe University, Melbourne, Australia; Imperial College Faculty of Medicine, Division of Neuroscience and Psychological Medicine, London, UK; Department of Experimental Psychology, Cambridge University, UK
P. MARUFF
Affiliation:
Melbourne Neuropsychiatry Centre, The University of Melbourne and Sunshine Hospital, Parkville and St. Albans, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia; ORYGEN Research Centre, The University of Melbourne, Parkville, Australia; North West Area Rehabilitation Services, NorthWestern Mental Health, Melbourne, Australia; La Trobe University, Melbourne, Australia; Imperial College Faculty of Medicine, Division of Neuroscience and Psychological Medicine, London, UK; Department of Experimental Psychology, Cambridge University, UK
G. W. STUART
Affiliation:
Melbourne Neuropsychiatry Centre, The University of Melbourne and Sunshine Hospital, Parkville and St. Albans, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia; ORYGEN Research Centre, The University of Melbourne, Parkville, Australia; North West Area Rehabilitation Services, NorthWestern Mental Health, Melbourne, Australia; La Trobe University, Melbourne, Australia; Imperial College Faculty of Medicine, Division of Neuroscience and Psychological Medicine, London, UK; Department of Experimental Psychology, Cambridge University, UK
W. J. BREWER
Affiliation:
Melbourne Neuropsychiatry Centre, The University of Melbourne and Sunshine Hospital, Parkville and St. Albans, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia; ORYGEN Research Centre, The University of Melbourne, Parkville, Australia; North West Area Rehabilitation Services, NorthWestern Mental Health, Melbourne, Australia; La Trobe University, Melbourne, Australia; Imperial College Faculty of Medicine, Division of Neuroscience and Psychological Medicine, London, UK; Department of Experimental Psychology, Cambridge University, UK
H. E. NELSON
Affiliation:
Melbourne Neuropsychiatry Centre, The University of Melbourne and Sunshine Hospital, Parkville and St. Albans, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia; ORYGEN Research Centre, The University of Melbourne, Parkville, Australia; North West Area Rehabilitation Services, NorthWestern Mental Health, Melbourne, Australia; La Trobe University, Melbourne, Australia; Imperial College Faculty of Medicine, Division of Neuroscience and Psychological Medicine, London, UK; Department of Experimental Psychology, Cambridge University, UK
T. W. ROBBINS
Affiliation:
Melbourne Neuropsychiatry Centre, The University of Melbourne and Sunshine Hospital, Parkville and St. Albans, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia; ORYGEN Research Centre, The University of Melbourne, Parkville, Australia; North West Area Rehabilitation Services, NorthWestern Mental Health, Melbourne, Australia; La Trobe University, Melbourne, Australia; Imperial College Faculty of Medicine, Division of Neuroscience and Psychological Medicine, London, UK; Department of Experimental Psychology, Cambridge University, UK
T. R. E. BARNES
Affiliation:
Melbourne Neuropsychiatry Centre, The University of Melbourne and Sunshine Hospital, Parkville and St. Albans, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia; ORYGEN Research Centre, The University of Melbourne, Parkville, Australia; North West Area Rehabilitation Services, NorthWestern Mental Health, Melbourne, Australia; La Trobe University, Melbourne, Australia; Imperial College Faculty of Medicine, Division of Neuroscience and Psychological Medicine, London, UK; Department of Experimental Psychology, Cambridge University, UK
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Abstract

Background. Behavioural syndromes (thought disturbance, social withdrawal, depressed behaviour and antisocial behaviour) offer a different perspective from that of symptomatic syndromes on the disability that may be associated with schizophrenia. Few studies have assessed their relationship with neuropsychological deficits. We hypothesized that these syndromes may represent behavioural manifestations of frontal-subcortical impairments, previously described in schizophrenia.

Method. Long-stay inpatients (n=54) and community patients (n=43) with enduring schizophrenia were assessed, using measures of symptoms and behaviour and tests of executive functioning. The relationship between syndromes and neuropsychological function was assessed using multiple regression and logistic regression analyses.

Results. Significant associations were found between performance on the spatial working memory task and the psychomotor poverty symptomatic syndrome, and between attentional set-shifting ability and both disorganization symptoms and the thought disturbance behavioural syndrome. These results were not explained by the effect of premorbid IQ, geographical location, length of illness or antipsychotic medication. Length of illness was an independent predictor of attentional set-shifting ability but not of working memory performance.

Conclusion. The specific relationship between negative symptoms and spatial working memory is consistent with involvement of the dorsolateral prefrontal cortex. The associations between difficulty with set-shifting ability and both disorganization symptoms and behaviours may reflect inability to generalize a rule that had been learned and impaired ability to respond flexibly. The specific relationship of illness duration to set-shifting ability may suggest progressive impairment on some executive tasks. The nature of these relationships and their neurobiological and rehabilitation implications are considered.

Type
Research Article
Information
Psychological Medicine , Volume 34 , Issue 4 , May 2004 , pp. 693 - 703
Copyright
© 2004 Cambridge University Press

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