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Reproducibility of Cognitive Profiles in Psychosis Using Cluster Analysis

Published online by Cambridge University Press:  18 October 2017

Kathryn E. Lewandowski ,
Justin T. Baker ,
Julie M. McCarthy ,
Lesley A. Norris  and
Dost Öngür
Kathryn E. Lewandowski*
Affiliation:
McLean Hospital, Schizophrenia and Bipolar Disorder Program, Belmont, Massachusetts Harvard Medical School, Department of Psychiatry, Boston, Massachusetts
Justin T. Baker
Affiliation:
McLean Hospital, Schizophrenia and Bipolar Disorder Program, Belmont, Massachusetts Harvard Medical School, Department of Psychiatry, Boston, Massachusetts
Julie M. McCarthy
Affiliation:
McLean Hospital, Schizophrenia and Bipolar Disorder Program, Belmont, Massachusetts Harvard Medical School, Department of Psychiatry, Boston, Massachusetts
Lesley A. Norris
Affiliation:
McLean Hospital, Schizophrenia and Bipolar Disorder Program, Belmont, Massachusetts
Dost Öngür
Affiliation:
McLean Hospital, Schizophrenia and Bipolar Disorder Program, Belmont, Massachusetts Harvard Medical School, Department of Psychiatry, Boston, Massachusetts
*
Correspondence and reprint requests to: Kathryn E. Lewandowski, McLean Hospital, 115 Mill Street, AB S349, Belmont, MA 02478. E-mail: [email protected]
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Abstract

Objectives: Cognitive dysfunction is a core symptom dimension that cuts across the psychoses. Recent findings support classification of patients along the cognitive dimension using cluster analysis; however, data-derived groupings may be highly determined by sampling characteristics and the measures used to derive the clusters, and so their interpretability must be established. We examined cognitive clusters in a cross-diagnostic sample of patients with psychosis and associations with clinical and functional outcomes. We then compared our findings to a previous report of cognitive clusters in a separate sample using a different cognitive battery. Methods: Participants with affective or non-affective psychosis (n=120) and healthy controls (n=31) were administered the MATRICS Consensus Cognitive Battery, and clinical and community functioning assessments. Cluster analyses were performed on cognitive variables, and clusters were compared on demographic, cognitive, and clinical measures. Results were compared to findings from our previous report. Results: A four-cluster solution provided a good fit to the data; profiles included a neuropsychologically normal cluster, a globally impaired cluster, and two clusters of mixed profiles. Cognitive burden was associated with symptom severity and poorer community functioning. The patterns of cognitive performance by cluster were highly consistent with our previous findings. Conclusions: We found evidence of four cognitive subgroups of patients with psychosis, with cognitive profiles that map closely to those produced in our previous work. Clusters were associated with clinical and community variables and a measure of premorbid functioning, suggesting that they reflect meaningful groupings: replicable, and related to clinical presentation and functional outcomes. (JINS, 2018, 24, 382–390)

Keywords

CognitionClusterSchizophreniaBipolar disorderPsychosisReplication
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 24 , Issue 4 , April 2018 , pp. 382 - 390
Copyright
Copyright © The International Neuropsychological Society 2017 

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