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Executive deficits in psychotic and bipolar disorders – Implications for our understanding of schizoaffective disorder

Published online by Cambridge University Press:  16 April 2020

Andrei Szoke*
Affiliation:
INSERM, U 841, F-94000Creèteil, France Universiteè Paris 12, Faculteè de Meèdecine, CreèteilF-94000, France AP-HP, GHU “Albert Chenevier e Henri Mondor”, Poôle de Psychiatrie, CreèteilF-94000, France
Alexandre Meary
Affiliation:
INSERM, U 841, F-94000Creèteil, France Universiteè Paris 12, Faculteè de Meèdecine, CreèteilF-94000, France AP-HP, GHU “Albert Chenevier e Henri Mondor”, Poôle de Psychiatrie, CreèteilF-94000, France
Anca Trandafir
Affiliation:
INSERM, U 841, F-94000Creèteil, France Universiteè Paris 12, Faculteè de Meèdecine, CreèteilF-94000, France
Frank Bellivier
Affiliation:
INSERM, U 841, F-94000Creèteil, France Universiteè Paris 12, Faculteè de Meèdecine, CreèteilF-94000, France AP-HP, GHU “Albert Chenevier e Henri Mondor”, Poôle de Psychiatrie, CreèteilF-94000, France
Isabelle Roy
Affiliation:
AP-HP, GHU “Albert Chenevier e Henri Mondor”, Poôle de Psychiatrie, CreèteilF-94000, France
Franck Schurhoff
Affiliation:
INSERM, U 841, F-94000Creèteil, France Universiteè Paris 12, Faculteè de Meèdecine, CreèteilF-94000, France AP-HP, GHU “Albert Chenevier e Henri Mondor”, Poôle de Psychiatrie, CreèteilF-94000, France
Marion Leboyer
Affiliation:
INSERM, U 841, F-94000Creèteil, France Universiteè Paris 12, Faculteè de Meèdecine, CreèteilF-94000, France AP-HP, GHU “Albert Chenevier e Henri Mondor”, Poôle de Psychiatrie, CreèteilF-94000, France
*
*Corresponding author. Service de Psychiatrie, Hôpital Albert Chenevier, 40 rue de Mesly, F-94000 Créteil, France. Tel.: +33 (0) 1 49 81 30 51; fax: +33 (0) 1 49 81 30 59.
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Abstract

Objective

Schizoaffective disorder could be considered as a form of schizophrenia, a form of bipolar disorder, an independent disorder or a disorder intermediate between bipolar disorder and schizophrenia, within a psychotic continuum. The study of cognitive deficits in subjects with those diagnoses could help differentiate between these possibilities.

Methods

We compared cognitive performances of schizoaffective (SZAff) subjects with those of subjects with schizophrenia (SZ), bipolar disorder with psychotic symptoms (life-time) (BDP), bipolar disorder without life-time occurrence of psychotic symptoms (BD) and normal controls (NC). We used two tests of executive functions – the Wisconsin Card Sorting Test (WCST) and the Trail-making Test (TMT) – that are known to be impaired in those disorders.

Results

The number of perseverative errors on WCST was highest in SZ subjects and gradually decreased in SZAff, BDP and, finally in BD subjects. By contrast, SZ and SZAff subjects obtained similar scores in the TMT, as did BD and BDP patients.

Conclusions

These results suggest that, for some deficits, there may be a continuum between SZ, SZAff and affective disorders, whereas SZAff patients most closely resemble SZ patients for other deficits. This implies that different conceptual views about schizoaffective disorder should be seen as complementary, rather than mutually exclusive.

Type
Original articles
Copyright
Copyright © Elsevier Masson SAS 2008

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