Various studies have demonstrated that psychotic patients have poor performance on the Wisconsin Card Sorting Test (WCST), which serves as an indicator of the dorsolateral prefrontal cortex executive functioning. The aim of our study was to compare cognitive performance of patients suffering from chronic psychosis with the first episode patients.

Our sample consisted of chronic schizophrenic and schizoaffective patients in worsening phase, the first episode patients and corresponding healthy controls. All patients were tested by WCST in the second week after the hospitalization, were treated with SGA, and had PANSS score above 60.

The performance of the psychotic patients was equal to the performance of healthy controls in all variables of the WCST, except the average non-perseverative responses (NPR) (p=0.01). NPR score indicates a state rather than shift in a cognitive set, so we performed the analysis of the given working memory test per diagnosis of the patients. The results showed lack of significant difference in the WCST performance between schizophrenic, schizoaffective and healthy subjects, whereas the first episode patients performed significantly worse then controls in the following variables: categories, perseverative errors and conceptualization level (p< 0.05).

Our findings showed difference in cognitive functioning between first episode patients and chronic psychotic patients. Better cognitive performance of chronic psychotic patients could be explained by potentially beneficial effects of the SGA pharmacotherapy to the cognitive status. However, this finding may be also limited by its association with age and relatively modest PANSS scores.