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Improvement in Prosocial Functioning After a Switch to Ziprasidone Treatment

Published online by Cambridge University Press:  07 November 2014

Antony Loebel ,
Cynthia Siu  and
Steven Romano
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Abstract

Background: Cognitive, social, and affective impairments are major features of schizophrenia, despite not being represented in the formal diagnostic criteria. These impairments are associated with major reductions in quality of life for patients with schizophrenia. Treatment with newer antipsychotic medications has been reported to improve all of these areas of functioning, but most studies have not examined the direct association between changes in cognitive functioning and other aspects of the illness.

Objectives: The goal of this analysis was to examine relationships between cognitive and affective symptoms and their impact on social impairments in patients switched to ziprasidone treatment.

Methods: In this study, which is a re-analysis of previously published data, 270 patients were switched from previous treatment with conventional antipsychotics, risperidone, or olanzapine to treatment with ziprasidone. Patients were tested with a cognitive assessment battery, rated with the Positive and Negative Syndrome Scale (PANSS), and received other assessments of safety and tolerability. PANSS scores were divided into factors based on previously published factor analyses, with a focus on the cognitive, prosocial, and anxiety-depression factors.

Results: Statistically significant improvements for global cognitive functioning and the three PANSS subscales were found across the studies. When the data were pooled for a path analysis, changes in cognitive functioning indexed by the PANSS cognitive subscales was the primary predictor of improvements in PANSS prosocial functions, with changes in anxiety-depression accounting for much less variance.

Conclusion: These results suggest a direct relationship between improvements in cognitive and prosocial functioning in patients with schizophrenia and indicate that treatments that enhance cognitive functioning, such novel antipsychotics, have the potential to improve aspects of outcome in schizophrenia even in short-term treatment studies. This issue should be addressed in future double-blind studies of the effects of atypical medications in schizophrenia.

Type
Original Research
Information
CNS Spectrums , Volume 9 , Issue 5 , May 2004 , pp. 357 - 363
Copyright
Copyright © Cambridge University Press 2004

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References

REFERENCES

1.Heinrichs, DW, Hallon, TE, Carpenter, WT Jr. The quality of life scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull. 1984;10:388–398.CrossRefGoogle ScholarPubMed
2.Hegarty, JD, Baldessarini, RJ, Tohen, M. One hundred years of schizophrenia: a meta-analysis of the outcome literature. Am J Psychiatry. 1994;151:1409–1416.Google ScholarPubMed
3.Dickerson, FB, Ringel, N, Parents, F. Predictors of residential independence among outpatients with schizophrenia. Psychiatr Serv. 1999;5:515–519.CrossRefGoogle Scholar
4.Macdonald, EM, Hayes, RL, Baglioni, AJ Jr. The quantity and quality of the social network of young people with early psychosis compared with closely matched controls. Schizophr Res. 2000;46:25–30.CrossRefGoogle Scholar
5.Haukka, J, Suvisaari, J, Lonnqvist, J. Fertility of patients with schizophrenia, their siblings, and the general population: a cohort study from 1950 to 1959 in Finland. Am J Psychiatry. 2003;160:460–463.CrossRefGoogle ScholarPubMed
6.Findling, RL, Jayathilake, K, Meltzer, HY. Pre-morbid associality in neuroleptic-resistant and neuroleptic-responsive schizophrenia. Psychol Med. 1996;26:1033–1041.CrossRefGoogle Scholar
7.Done, DJ, Crow, TJ, Johnstone, EC, Sacker, A. Childhood antecedents of schizophrenia and affective illness: social adjustment at ages 7 and 11. BMJ. 1994;309:699–703.CrossRefGoogle ScholarPubMed
8.Mueser, KT, Penn, DL, Blanchard, JJ, et al.Affect recognition in schizophrenia: a synthesis of findings across studies. J Abnorm Psychol. 1996;105:271–275.CrossRefGoogle Scholar
9.Kring, AT, Neale, JM. Do schizophrenia patients show a disjunctive relationship between expressive, experiential, and psychophysiological components of emotion? J Abnorm Psychol. 1996:105:249–257.CrossRefGoogle ScholarPubMed
10.Green, MF. What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry. 1996;153:321–330Google ScholarPubMed
11.Green, MF, Kern, RS, Braff, D, Mintz, J. Neurocognition and functional outcome in schizophrenia: are we measuring the “right stuff”? Schizophr Bull. 2000;26:119–136.CrossRefGoogle ScholarPubMed
12.Harvey, PD, Keefe, RS. Interpreting studies of cognitive change in schizophrenia with novel antipsychotic treatment. Am J Psychiatry. 2001;158:176–184CrossRefGoogle ScholarPubMed
13.Leucht, S, Pitschel-Walz, G, Engel, RR, Kissling, W. Amisulpride an unusual “atypical” antipsychptic: a meta-analysis of randomized controlled trials. Am J Psychiatry. 2002;159:180–190.CrossRefGoogle ScholarPubMed
14.Harvey, PD, Moriarty, PJ, Serper, MR, Schnur, E, Lieber, D. Practice-related improvement in information processing with novel antipsychotic treatment. Schizophr Res. 2000;46:139–148.CrossRefGoogle ScholarPubMed
15.Harvey, PD, Meltzer, HY, Simpson, GM, et al.Improvement in cognitive function following a switch to ziprasidone from conventional antipsychotics, olanzapine, or risperidone in outpatients with schizophrenia. Schizophr Res. 2004;66:101–114.CrossRefGoogle ScholarPubMed
16.Kring, AM, Alpert, M, Neale, JM, Harvey, PD. A multimethod, multichannel assessment of affective flattening in schizophrenia. Psychiatry Res. 1994:54:211–222.CrossRefGoogle ScholarPubMed
17.Siris, SG, Harmon, GK, Endicott, J. Postpsychotic depressive symptoms in hospitalized schizophrenic patients. Arch Gen Psychiatry. 1981;28:1122–1123.CrossRefGoogle Scholar
18.Addington, DD, Azorin, JM, Falloon, IR, Gerlach, J, Hirsch, SR, Siris, SG. Clinical issues related to depression in schizophrenia: an international survey of psychiatrists. Acta Psychiatr Scand. 2002;105:189–195.CrossRefGoogle ScholarPubMed
19.Meltzer, HY, Alphs, L, Green, AI, et al.Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT). Arch Gen Psychiatry. 2003;60:82–91.CrossRefGoogle ScholarPubMed
20.Weiden, PJ, Simpson, GM, Potkin, SG, O'Sullivan, RL. Effectiveness of switching to ziprasidone for stable but symptomatic outpatients with schizophrenia. J Clin Psychiatry. 2003;64;580–588.CrossRefGoogle ScholarPubMed
21.Weiden, PJ, Daniel, DG, Simpsom, G, Romano, SJ. Improvement in indices of health status in outpatients with schizophrenia switched to ziprasidone. J Clin Psychopharmocol. 2003;23:595–600.CrossRefGoogle ScholarPubMed
22.Kay, SR. Positive and Negative Syndromes in Schizophrenia. New York, NY: Brunner/Mazel; 1991.Google ScholarPubMed
23.Jastak, S. The Wide-Range Achievement Test-Revised. Wilmington, DE: Jastak Associates; 1984.Google Scholar
24.Spreen, O, Strauss, E. A Compendium of Neuropsychological Tests and Norms. 2nd ed. New York, NY: Oxford University Press; 1998.Google Scholar
25.Meltzer, HY, McGurk, SR. The effects of clozapine, risperidone, and olanzapine on cognitive function in schizophrenia. Schizophr Bull. 1999;25:233–255.CrossRefGoogle ScholarPubMed
26.Cornblatt, BA, Lenzenweger, MF, Erlenmeyer-Kimling, L. The continuous performance test, identical pairs version: II. Contrasting attentional profiles in schizophrenic and depressed patients. Psychiatry Res. 1989;29:65–85CrossRefGoogle ScholarPubMed
27.Oltmanns, TF, Neale, JM. Schizophrenic performance when distractors are present: attentional deficit or differential task difficulty? J Abnorm Psychol. 1975;84:205–209.CrossRefGoogle ScholarPubMed
28.Heaton, RK, Chelune, CJ, Talley, JL, Kay, GG, Curtiss, G. Wisconsin Card Sorting Test Manual–Revised and Expanded. Odessa, FL: Psychological Assessment Resources; 1993.Google Scholar
29.Lindenmeyer, JP, Bernstein-Hyman, R, Grochowski, S. A new five-factor model of schizophrenia. Psychiatric Q. 1994;299–322.Google Scholar
30.Purnine, DM, Carey, KB, Maistro, SM, Karey, MP. Assessing positive and negative symptoms in patients with schizophrenia and mood disorders. J Nerv Ment Dis. 2000;188:653–661.CrossRefGoogle Scholar
31.Buchanan, RW, Holstein, C, Breier, A. The comparative efficacy and long-term effect of clozapine treatment on neuropsychological test performance. Biol Psychiatry. 1994;36:717–725CrossRefGoogle ScholarPubMed
32.Harvey, PD, Serper, MR, White, L, et al.The convergence of neuropsychological testing and clinical ratings of cognitive impairment in patients with schizophrenia. Compr Psychiatry. 2001;42:306–313CrossRefGoogle ScholarPubMed
33.Axelsson, R, Lagerkvist-Briggs, M. Factors predicting suicide in psychotic patients. Eur Arch Psychiatry Clin Neurosci. 1992;241:259–266.CrossRefGoogle ScholarPubMed
34.Keck, PE Jr, Reeves, KR, Harrigan, EP. Ziprasidone in the short-term treatment of patients with schizoaffective disorder: results from two double-blind place-controlled Multicenter studies. J Clin Psychopharmocol. 2001;21:27–35.CrossRefGoogle Scholar