Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-26T04:55:29.588Z Has data issue: false hasContentIssue false
  • English
  • Français

Discriminant cognitive factors in responder and non-responder patients with schizophrenia

Published online by Cambridge University Press:  16 April 2020

E. Stip ,
I. Lussier ,
E. Ngan ,
A. Mendrek  and
P. Liddle
E. Stip
Affiliation:
Centre de recherche Fernand Seguin, Hôpital L.H. Lafontaine, Université de Montréal, 7331 rue Hochelaga, Montreal HIN 3V2 Québec Department of Psychiatry, University of British Columbia, Vancouver, Canada
I. Lussier
Affiliation:
Centre de recherche Fernand Seguin, Hôpital L.H. Lafontaine, Université de Montréal, 7331 rue Hochelaga, Montreal HIN 3V2 Québec
E. Ngan
Affiliation:
Department of Psychiatry, University of British Columbia, Vancouver, Canada
A. Mendrek
Affiliation:
Department of Psychiatry, University of British Columbia, Vancouver, Canada
P. Liddle
Affiliation:
Department of Psychiatry, University of British Columbia, Vancouver, Canada
Get access

Summary

To identify which improvements in cognitive function are associated with symptom resolution in schizophrenic patients treated with atypical antipsychotics. Design: a prospective open trial with atypical neuroleptics (risperidone, clozapine, quetiapine). Setting: Inpatient and outpatient units, Institute of Psychiatry. Patients: Thirty-nine patients with schizophrenia according to DSM-IV criteria were included. Clinical and cognitive assessment were done at baseline (T0) and again after six months of treatment (T2). Twenty-five patients completed the trial. Interventions: New-generation antipsychotics during six months. Patients were considered as responders if their PANSS score decreased at least 20% (n = 15) and non-responders if it did not (n = 10). Outcome measures: a computerized cognitive assessment comprised tests of short-term-memory (digit span), explicit long-term memory (word pair learning), divided attention, selective attention and verbal fluency (orthographic and semantic). Clinical assessment included PANSS and ESRS. Results: A discriminant function analysis was performed to determine which changes in cognitive performance predicted symptomatic response status. Semantic fluency and orthographic fluency were significant predictors. Together they correctly predicted responder status in 88% of cases. Memory was not a significant predictor of symptomatic response. Conclusion: Verbal fluency discriminated the responder from the non-responder group during a pharmacological treatment.

Keywords

antipsychoticclozapinecognitionquetiapineresponderrisperidoneschizophreniaverbal fluency
Type
Original article
Information
European Psychiatry , Volume 14 , Issue 8 , December 1999 , pp. 442 - 450
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 1999

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

Allen, H.AFrith, C.DSelective retrieval and free emission of category examplars in schizophrenia Br J Psychol 74 1983 481–490CrossRefGoogle Scholar
Allen, H.ALiddle, P.FFrith, C.DNegative features, retrieval processes and verbal fluency in schizophrenia Br J Psychiatry 163 1993 769–775CrossRefGoogle Scholar
Arvanitis, L.AMiller, B.GSeroquel Trial 13 Study Group. Multiple fixed doses of ‘Seroquelߣ (Quetiapine) in patients with acute exacerbation of schizophrenia: a comparison with haloperidol and placebo Biol Psychiatry 42 1997 233–246CrossRefGoogle Scholar
Azorin, J.MRemington, GPere, J.JBourdeix, IComparaison du Leponex avec la Risperidone dans les schizophrenies chroniques severes L'information Psychiatrique 1999 in pressGoogle Scholar
Bellack, A.SGold, J.MBuchanan, R.WCognitive rehabilitation for schizophrenia: problems, prospects, and strategies Schizophr Bull. 25 1999 257–274CrossRefGoogle ScholarPubMed
Breier, AMalhotra, ATung-Ping, S.UPinals, DElman, IAdler, CClozapine and risperidone in chronic schizophrenia: effects on symptoms, Parkinsonian side effecst, and neuroendocrine response Am J Psy 156 1999 294–298Google Scholar
Bub, DGum, TPsychlab software 1987 McGill UniversityGoogle Scholar
Butters, NWolfe, JGranholm, EMartone, MAn assessment of verbal recall, recognition and fluency abilities in patients with Huntington's disease Cortex 22 1986 11–32CrossRefGoogle ScholarPubMed
Chatelois, JPineau, HBelleville, SPeretz, ILussier, IFontaine, FBatterie informatisée d'évaluation de la mémoire inspirée de l'approche cognitive Rev Can Psychol 34 1993 44–63Google Scholar
Chouinard, GRoss-Chouinard, AAnnable, LJones, B.DExtra-pyramidal Symptom Rating Scale Can J Neurol Sci 7 1980 233Google Scholar
Crawford, J.RObonsawin, M.CBremmer, MFrontal lobe impairment in schizophrenia: relationship to intellectual function Psychol M 23 1993 787–790CrossRefGoogle Scholar
Crow, T.JThe molecular pathology of schizophrenia BMJ 280 1980 66–68CrossRefGoogle ScholarPubMed
Frith, C.DThe cognitive neuropsychology of schizophrenia 1992 Hove, UK: Lawrence ErlbaumGoogle Scholar
Frith, C.DAllen, H.ALanguage disorders in schizophrenia and their implications for neuropsychologyBeddington, PMcguffin, PSchizophrenia: the major issues 1988 Oxford: Heinemann MedicalGoogle Scholar
Goldberg, TAloia, MGourovitch, MMissar, DPickar, DWeinberger, DCognitive substrates of thought disorder. I: The Semantic System Am J Psychiatry 155 1998 1671–1676CrossRefGoogle ScholarPubMed
Goldberg, T.EGreenberg, R.DGriffin, S.JGold, J.MKleinman, J.EPickar, DThe effect of clozapine on cognition and psychiatric symptoms in patients with schizophrenia Br J Psychiatry 162 1993 43–48CrossRefGoogle ScholarPubMed
Green, M.FWalker, ENeuropsychological performance and positive and negative symptoms of schizophrenia J Abnorm Psychol 94 1985 460–469CrossRefGoogle ScholarPubMed
Green, M.FWhat are the functional consequences of neurocognitive deficits in schizophrenia Am J Psychiatry 153 1996 321–330Google Scholar
Green, M.FNuechterlein, K.HShould schizophrenia be treated as a neurocognitive disorder? Schizophr Bull 25 1999 309–318CrossRefGoogle ScholarPubMed
Gruzelier, JSeymour, KWilson, LJolley, AHirsch, SImpairments of neuropsychological tests of temporohippocampol functions and word fluency in remitting schizophrenia and affective disorders Arch Gen Psychiatry 45 1988 623–629CrossRefGoogle ScholarPubMed
Gurd, J.MWard, C.DRetrieval from semantic and letter-initial categories in patients with Parkinson's disease Neuropsychologia 28 1989 737–741Google Scholar
Hagger, CBuckley, PKenny, J.TFreidman, LUbogy, DMeltzer, H.YImprovement in cognitive functions and psychiatric symptoms in treatment-refractory schizophrenic patients receiving clozapine Biol Psychiatry 34 1993 702–712CrossRefGoogle ScholarPubMed
Hodges, J.RSalmon, D.PButters, NDifferential impairment of episodic and semantic memory in Alzheimer's and Huntington's disease: a control prospective study J Neurol Neurosurg Psychiatry 53 1990 1089–1095CrossRefGoogle Scholar
Janowsky, J.SShimamura, A.PKritchensky, MSquire, L.RCognitive impairment following frontal lobe damage and its relevance to human amnesia Behav Neurosci 103 1989 548–560CrossRefGoogle ScholarPubMed
Joyce, E.MCollinson, S.LCrichton, PVerbal fluency in schizophrenia: relationship with executive function, semantic memory and clinical alogia Psychol M 26 1996 39–49CrossRefGoogle ScholarPubMed
Kane, JHonigfeld, GSinger, JMeltzer, HClozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine Arch Gen Psychiatry 45 1988 789–796CrossRefGoogle ScholarPubMed
Kay, S.RFiszbein, AOpler, L.AThe positive and negative syndrome scale Schizophr Bull 13 1987 261–276CrossRefGoogle ScholarPubMed
Keefe, RSilva, S.GPerkins, D.OLieberman, J.AThe effects of atypical antipsychotic drugs on neurocognitive impairment in schizophrenia: A review and meta-analysis Schizophr Bull 25 1999 201–222CrossRefGoogle ScholarPubMed
Kolb, BWishaw, I.QPerformance of schizophrenic patients on tests sensitive to left or right frontal, temporal or parietal function in neurological patients J Nerv Ment Dis 171 1983 435–443CrossRefGoogle ScholarPubMed
Liddle, P.FSchizophrenic syndromes, cognitive performance and neurological dysfunction Psychol M 17 1987 49–57CrossRefGoogle ScholarPubMed
Martin, AFedio, PWord production and comprehension in Alzheimer's disease: the break down of semantic knowledge Brain Lang 19 1983 124–141CrossRefGoogle Scholar
Martin, R.CLoring, D.WMeador, K.JLee, G.PThe effects of lateralized temporal lobe dysfunction on frontal and semantic fluency Neuropsychologia 28 1990 823–829CrossRefGoogle Scholar
Meltzer, HUtilization, multidimensional outcome measures, and risk-benefit considerations for the use of clozapine in schizophreniaBrunelle, NMendlewicz, JRacagni, GNew Generation of Antipsychotic Drugs: Novel mechanisms of action. Vol. 4 1993 Basel: Karger 103–117Google Scholar
Milner, BSome effects of frontal lobectomy in manWarren, J.MAkert, KThe Frontal Granular Cortex and Behaviour 1964 New York: McGraw-Hill 313–344Google Scholar
Norman, RMalla, ACortese, LCheng, SDiaz, KMcIntosh, ESymptoms and cognition as predictors of community functioning: a prospective analysis Am J Psychiatry 156 1999 400–405Google ScholarPubMed
Overall, J.EGorham, D.RBrief Psychiatric Rating Scale Psychol Rep 10 1962 799–812CrossRefGoogle Scholar
Pasquier, FLebert, FGrymonprez, LPetit, HVerbal fluency in dementia of frontal lobe type and dementia of Alzheimer type J Neurol Neurosurg Psychiatry 58 1995 81–84CrossRefGoogle ScholarPubMed
Paulesu, EFrith, C.DFrackoviak, R.SThe neural correlates of the verbal component of working memory Nature 362 1993 342–345CrossRefGoogle ScholarPubMed
Pillon, BDubois, BLhermitte, FAgid, YHeterogeneity of cognitive impairment in progressive supranuclear palsy, Parkinson's disease and Alzheimer's disease Neurology 36 1986 1179–1185CrossRefGoogle ScholarPubMed
Robert, P.HMigneco, VMarmod, DChaix, IThauby, SBenoit, MVerbal fluency in schizophrenia: the role of semantic clustering in category instance generation Eur Psychiatry 12 1997 124–129CrossRefGoogle ScholarPubMed
Robert, P.HThauby, VMigneco, ICaci, HBenoit, MBeau, C.HDifférenciation de sous-types de troubles schizophréniques en fonction des performances au test de fluence verbale L'Encéphale 23 1996 435–442Google Scholar
Saykin, A.JGur, R.CGur, R.EMozley, P.DMozley, L.HResnick, S.MNeuropsychological function in schizophrenia: selective impairment in memory and learning Arch Gen Psychiatry 48 1991 618–624CrossRefGoogle ScholarPubMed
Stip, EMemory impairment in schizophrenia: perspectives from psychopathology and pharmacotherapy Can J Psychiatry 41 Suppl 2 1996 S27–S34CrossRefGoogle ScholarPubMed
Stip, ELussier, ICoron, AMVerbal fluency discriminates the responder group from the non-responder group during a pharmacological treatment Schizophr Res 36 1999 155Google Scholar
Tran, P.VHamilton, S.HKuntz, A.JPotvin, J.HAndersen, S.WBeasley, C et al. Double blind comparison of olanzapine versus risperidone in the treatment of schizophrenia and other psychotic disorders J Clin Psychopharmacol 17 1997 407–418CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.