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Cognition in schizophrenia and schizo-affective disorder: impairments that are more similar than different

Published online by Cambridge University Press:  27 March 2013

A. Owoso ,
C. S. Carter ,
J. M. Gold ,
A. W. MacDonald III ,
J. D. Ragland ,
S. M. Silverstein ,
M. E. Strauss  and
D. M. Barch
A. Owoso*
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
C. S. Carter
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA
J. M. Gold
Affiliation:
Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
A. W. MacDonald III
Affiliation:
Department of Psychology, University of Minnesota, Minneapolis, MN, USA
J. D. Ragland
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA
S. M. Silverstein
Affiliation:
Division of Schizophrenia Research, University of Medicine and Dentistry of New Jersey, Piscataway, NJ, USA
M. E. Strauss
Affiliation:
Department of Psychology, Case Western Reserve University, Cleveland, OH, USA
D. M. Barch
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
*
*Address for correspondence: A. Owoso, M.D., Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8134, St Louis, MO 63110, USA. (Email: [email protected])
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Abstract

Background

Cognition is increasingly being recognized as an important aspect of psychotic disorders and a key contributor to functional outcome. In the past, comparative studies have been performed in schizophrenia and schizo-affective disorder with regard to cognitive performance, but the results have been mixed and the cognitive measures used have not always assessed the cognitive deficits found to be specific to psychosis. A set of optimized cognitive paradigms designed by the Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia (CNTRACS) Consortium to assess deficits specific to schizophrenia was used to measure cognition in a large group of individuals with schizophrenia and schizo-affective disorder.

Method

A total of 519 participants (188 with schizophrenia, 63 with schizo-affective disorder and 268 controls) were administered three cognitive paradigms assessing the domains of goal maintenance in working memory, relational encoding and retrieval in episodic memory and visual integration.

Results

Across the three domains, the results showed no major quantitative differences between patient groups, with both groups uniformly performing worse than healthy subjects.

Conclusions

The findings of this study suggests that, with regard to deficits in cognition, considered a major aspect of psychotic disorder, schizophrenia and schizo-affective disorder do not demonstrate major significant distinctions. These results have important implications for our understanding of the nosological structure of major psychopathology, providing evidence consistent with the hypothesis that there is no natural distinction between cognitive functioning in schizophrenia and schizo-affective disorder.

Keywords

Cognitive performancediagnostic validitygoal maintenancememory encodingnosologypsychosisvisual processing
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 12 , December 2013 , pp. 2535 - 2545
Copyright
Copyright © Cambridge University Press 2013 

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References

Abrams, DJ, Rojas, DC, Arciniegas, DB (2008). Is schizoaffective disorder a distinct categorical diagnosis? A critical review of the literature. Neuropsychiatric Disease and Treatment 4, 1089–1109.CrossRefGoogle ScholarPubMed
Amann, B, Gomar, JJ, Ortiz-Gil, J, McKenna, P, Sans-Sansa, B, Sarro, S, Moro, N, Madre, M, Landin-Romero, R, Vieta, E, Giokolea, JM, Salvador, R, Pomarol-Clotet, E (2012). Executive dysfunction and memory impairment in schizoaffective disorder: a comparison with bipolar disorder, schizophrenia and healthy controls. Psychological Medicine 42, 2127–2135.CrossRefGoogle ScholarPubMed
Barch, DM (2009). Neuropsychological abnormalities in schizophrenia and major mood disorders: similarities and differences. Current Psychiatry Reports 11, 313–319.CrossRefGoogle ScholarPubMed
Barch, DM, Carter, CS, Arnsten, A, Buchanan, RW, Cohen, JD, Geyer, M, Green, MF, Krystal, JH, Nuechterlein, K, Robbins, T, Silverstein, S, Smith, EE, Strauss, M, Wykes, T, Heinssen, R (2009). Selecting paradigms from cognitive neuroscience for translation into use in clinical trials: proceedings of the third CNTRICS meeting. Schizophrenia Bulletin 35, 109–114.CrossRefGoogle ScholarPubMed
Barch, DM, Carter, CS, Dakin, SC, Gold, J, Luck, SJ, MacDonald, A 3rd, Ragland, JD, Silverstein, S, Strauss, ME (2012). The clinical translation of a measure of gain control: the Contrast-Contrast Effect task. Schizophrenia Bulletin 38, 135–143.CrossRefGoogle ScholarPubMed
Barch, DM, Carter, CS, MacDonald, AW 3rd, Braver, TS, Cohen, JD (2003). Context-processing deficits in schizophrenia: diagnostic specificity, 4-week course, and relationships to clinical symptoms. Journal of Abnormal Psychology 112, 132–143.CrossRefGoogle ScholarPubMed
Bora, E, Yucel, M, Pantelis, C (2009). Cognitive functioning in schizophrenia, schizoaffective disorder and affective psychoses: meta-analytic study. British Journal of Psychiatry 195, 475–482.CrossRefGoogle ScholarPubMed
Cheniaux, E, Landeira-Fernandez, J, Lessa Telles, L, Lessa, JL, Dias, A, Duncan, T, Versiani, M (2008). Does schizoaffective disorder really exist? A systematic review of the studies that compared schizoaffective disorder with schizophrenia or mood disorders. Journal of Affective Disorders 106, 209–217.CrossRefGoogle ScholarPubMed
Cohen, JD, Barch, DM, Carter, C, Servan-Schreiber, D (1999). Context-processing deficits in schizophrenia: converging evidence from three theoretically motivated cognitive tasks. Journal of Abnormal Psychology 108, 120–133.CrossRefGoogle ScholarPubMed
Craddock, N, O'Donovan, MC, Owen, MJ (2009). Psychosis genetics: modeling the relationship between schizophrenia, bipolar disorder, and mixed (or ‘schizoaffective’) psychoses. Schizophrenia Bulletin 35, 482–490.CrossRefGoogle ScholarPubMed
Field, DJ, Hayes, A, Hess, RF (1993). Contour integration by the human visual system: evidence for a local ‘association field’. Vision Research 33, 173–193.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Miriam, G, Williams, JBW (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-Patient Edition (SCID-I/NP). Biometrics Research, New York State Psychiatric Institute: New York.Google Scholar
Fiszdon, JM, Richardson, R, Greig, T, Bell, MD (2007). A comparison of basic and social cognition between schizophrenia and schizoaffective disorder. Schizophrenia Research 91, 117–121.CrossRefGoogle ScholarPubMed
Gold, JM, Barch, DM, Carter, CS, Dakin, S, Luck, SJ, MacDonald, AW 3rd, Ragland, JD, Ranganath, C, Kovacs, I, Silverstein, SM, Strauss, M (2012). Clinical, functional, and intertask correlations of measures developed by the Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia Consortium. Schizophrenia Bulletin 38, 144–152.CrossRefGoogle ScholarPubMed
Goldstein, G, Shemansky, WJ, Allen, DN (2005). Cognitive function in schizoaffective disorder and clinical subtypes of schizophrenia. Archives of Clinical Neuropsychology 20, 153–159.CrossRefGoogle ScholarPubMed
Green, MF (1996). What are the functional consequences of neurocognitive deficits in schizophrenia? American Journal of Psychiatry 153, 321–330.Google ScholarPubMed
Green, MF, Butler, PD, Chen, Y, Geyer, MA, Silverstein, S, Wynn, JK, Yoon, JH, Zemon, V (2009). Perception measurement in clinical trials of schizophrenia: promising paradigms from CNTRICS. Schizophrenia Bulletin 35, 163–181.CrossRefGoogle ScholarPubMed
Green, MF, Kern, RS, Heaton, RK (2004). Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophrenia Research 72, 41–51.CrossRefGoogle ScholarPubMed
Harvey, PD, Velligan, DI, Bellack, AS (2007). Performance-based measures of functional skills: usefulness in clinical treatment studies. Schizophrenia Bulletin 33, 1138–1148.CrossRefGoogle ScholarPubMed
Heckers, S (2009). Is schizoaffective disorder a useful diagnosis? Current Psychiatry Reports 11, 332–337.CrossRefGoogle ScholarPubMed
Heinrichs, RW, Ammari, N, McDermid Vaz, S, Miles, AA (2008). Are schizophrenia and schizoaffective disorder neuropsychologically distinguishable? Schizophrenia Research 99, 149–154.CrossRefGoogle ScholarPubMed
Henderson, D, Poppe, AB, Barch, DM, Carter, CS, Gold, JM, Ragland, JD, Silverstein, SM, Strauss, ME, MacDonald, AW 3rd (2012). Optimization of a goal maintenance task for use in clinical applications. Schizophrenia Bulletin 38, 104–113.CrossRefGoogle ScholarPubMed
Insel, T, Cuthbert, B, Garvey, M, Heinssen, R, Pine, DS, Quinn, K, Sanislow, C, Wang, P (2010). Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. American Journal of Psychiatry 167, 748–751.CrossRefGoogle Scholar
Jones, JA, Sponheim, SR, MacDonald, AW 3rd (2010). The dot pattern expectancy task: reliability and replication of deficits in schizophrenia. Psychological Assessment 22, 131–141.CrossRefGoogle ScholarPubMed
Kantrowitz, JT, Citrome, L (2011). Schizoaffective disorder: a review of current research themes and pharmacological management. CNS Drugs 25, 317–331.CrossRefGoogle ScholarPubMed
Knight, RA, Silverstein, SM (2001). A process-oriented approach for averting confounds resulting from general performance deficiencies in schizophrenia. Journal of Abnormal Psychology 110, 15–30.CrossRefGoogle ScholarPubMed
MacDonald, AW 3rd (2008). Building a clinically relevant cognitive task: case study of the AX paradigm. Schizophrenia Bulletin 34, 619–628.CrossRefGoogle ScholarPubMed
Maj, M, Pirozzi, R, Formicola, AM, Bartoli, L, Bucci, P (2000). Reliability and validity of the DSM-IV diagnostic category of schizoaffective disorder: preliminary data. Journal of Affective Disorders 57, 95–98.CrossRefGoogle ScholarPubMed
Malhi, GS, Green, M, Fagiolini, A, Peselow, ED, Kumari, V (2008). Schizoaffective disorder: diagnostic issues and future recommendations. Bipolar Disorders 10, 215–230.CrossRefGoogle ScholarPubMed
Mathalon, DH, Hoffman, RE, Watson, TD, Miller, RM, Roach, BJ, Ford, JM (2010). Neurophysiological distinction between schizophrenia and schizoaffective disorder. Frontiers in Human Neuroscience 3, 70.Google ScholarPubMed
Morris, SE, Cuthbert, BN (2012). Research Domain Criteria: cognitive systems, neural circuits, and dimensions of behavior. Dialogues in Clinical Neuroscience 14, 29–37.CrossRefGoogle ScholarPubMed
Nurnberger, JI Jr., Blehar, MC, Kaufmann, CA, York-Cooler, C, Simpson, SG, Harkavy-Friedman, J, Severe, JB, Malaspina, D, Reich, T (1994). Diagnostic interview for genetic studies. Rationale, unique features, and training. NIMH Genetics Initiative. Archives of General Psychiatry 51, 849–859; discussion 863–864.CrossRefGoogle ScholarPubMed
Overall, JE, Gorham, DR (1962). The brief psychiatric rating scale. Psychological Reports 10, 799.CrossRefGoogle Scholar
Patterson, TL, Goldman, S, McKibbin, CL, Hughs, T, Jeste, DV (2001). UCSD Performance-Based Skills Assessment: development of a new measure of everyday functioning for severely mentally ill adults. Schizophrenia Bulletin 27, 235–245.CrossRefGoogle ScholarPubMed
Ragland, JD, Cools, R, Frank, M, Pizzagalli, DA, Preston, A, Ranganath, C, Wagner, AD (2009). CNTRICS final task selection: long-term memory. Schizophrenia Bulletin 35, 197–212.CrossRefGoogle ScholarPubMed
Ragland, JD, Ranganath, C, Barch, DM, Gold, JM, Haley, B, MacDonald, AW 3rd, Silverstein, SM, Strauss, ME, Yonelinas, AP, Carter, CS (2012). Relational and Item-Specific Encoding (RISE): task development and psychometric characteristics. Schizophrenia Bulletin 38, 114–124.CrossRefGoogle ScholarPubMed
Reichenberg, A, Harvey, PD, Bowie, CR, Mojtabai, R, Rabinowitz, J, Heaton, RK, Bromet, E (2009). Neuropsychological function and dysfunction in schizophrenia and psychotic affective disorders. Schizophrenia Bulletin 35, 1022–1029.CrossRefGoogle ScholarPubMed
Sanislow, CA, Pine, DS, Quinn, KJ, Kozak, MJ, Garvey, MA, Heinssen, RK, Wang, PS, Cuthbert, BN (2010). Developing constructs for psychopathology research: research domain criteria. Journal of Abnormal Psychology 119, 631–639.CrossRefGoogle ScholarPubMed
Schneider, LC, Struening, EL (1983). SLOF: a behavioral rating scale for assessing the mentally ill. Social Work Research and Abstracts 19, 9–21.CrossRefGoogle ScholarPubMed
Schwartz, JE, Fennig, S, Tanenberg-Karant, M, Carlson, G, Craig, T, Galambos, N, Lavelle, J, Bromet, EJ (2000). Congruence of diagnoses 2 years after a first-admission diagnosis of psychosis. Archives of General Psychiatry 57, 593–600.CrossRefGoogle ScholarPubMed
Servan-Schreiber, D, Cohen, JD, Steingard, S (1996). Schizophrenic deficits in the processing of context. A test of a theoretical model. Archives of General Psychiatry 53, 1105–1112.CrossRefGoogle ScholarPubMed
Silverstein, SM, Keane, BP (2011). Perceptual organization impairment in schizophrenia and associated brain mechanisms: review of research from 2005 to 2010. Schizophrenia Bulletin 37, 690–699.CrossRefGoogle ScholarPubMed
Silverstein, SM, Keane, BP, Barch, DM, Carter, CS, Gold, JM, Kovacs, I, MacDonald, A 3rd, Ragland, JD, Strauss, ME (2012). Optimization and validation of a visual integration test for schizophrenia research. Schizophrenia Bulletin 38, 125–134.CrossRefGoogle ScholarPubMed
Silverstein, SM, Knight, RA, Schwarzkopf, SB, West, LL, Osborn, LM, Kamin, D (1996). Stimulus configuration and context effects in perceptual organization in schizophrenia. Journal of Abnormal Psychology 105, 410–420.CrossRefGoogle ScholarPubMed
Smith, MJ, Barch, DM, Csernansky, JG (2009). Bridging the gap between schizophrenia and psychotic mood disorders: relating neurocognitive deficits to psychopathology. Schizophrenia Research 107, 69–75.CrossRefGoogle Scholar
Stip, E, Sepehry, AA, Prouteau, A, Briand, C, Nicole, L, Lalonde, P, Lesage, A (2005). Cognitive discernible factors between schizophrenia and schizoaffective disorder. Brain and Cognition 59, 292–295.CrossRefGoogle ScholarPubMed
Strauss, M, Summerfelt, A (1994). Response to Serper and Harvey. Schizophrenia Bulletin 20, 13–21.CrossRefGoogle Scholar
Twamley, EW, Doshi, RR, Nayak, GV, Palmer, BW, Golshan, S, Heaton, RK, Patterson, TL, Jeste, DV (2002). Generalized cognitive impairments, ability to perform everyday tasks, and level of independence in community living situations of older patients with psychosis. American Journal of Psychiatry 159, 2013–2020.CrossRefGoogle ScholarPubMed
Uhlhaas, PJ, Phillips, WA, Mitchell, G, Silverstein, SM (2006). Perceptual grouping in disorganized schizophrenia. Psychiatry Research 145, 105–117.CrossRefGoogle ScholarPubMed
Velligan, DI, Mahurin, RK, Diamond, PL, Hazleton, BC, Eckert, SL, Miller, AL (1997). The functional significance of symptomatology and cognitive function in schizophrenia. Schizophrenia Research 25, 21–31.CrossRefGoogle ScholarPubMed
Ventura, J, Green, MF, Shaner, A, Liberman, RP (1993 a). Training and quality assurance on the Brief Psychiatric Rating Scale: the ‘drift busters’. International Journal of Methods in Psychiatry Research 3, 221–226.Google Scholar
Ventura, J, Lukoff, D, Nuechterlein, KH, Liberman, RP, Green, MF, Shaner, A (1993 b). Brief Psychiatric Rating Scale (BPRS) expanded version: scales, anchor points, and administration manual. International Journal of Methods in Psychiatry Research 3, 227–243.Google Scholar
Ventura, J, Nuechterlein, KH, Subotnik, KL, Gutkind, D, Gilbert, EA (2000). Symptom dimensions in recent-onset schizophrenia and mania: a principal components analysis of the 24-item Brief Psychiatric Rating Scale. Psychiatry Research 97, 129–135.CrossRefGoogle Scholar
Vesterager, L, Christensen, TO, Olsen, BB, Krarup, G, Melau, M, Forchhammer, HB, Nordentoft, M (2012). Cognitive and clinical predictors of functional capacity in patients with first episode schizophrenia. Schizophrenia Research 141, 251–256.CrossRefGoogle ScholarPubMed
Wichmann, FA, Hill, NJ (2001). The psychometric function: I. Fitting, sampling, and goodness of fit. Perception and Psychophysics 63, 1293–1313.CrossRefGoogle ScholarPubMed
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Owoso Supplementary Material

Tables S1-S4

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Figure S1: Graph showing performance on Dot Probe Expectancy (DPX) task with number of errors for each of the four trial types (AX, AY, BX, BY). Error bars are standard errors.

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Figure S2: Bar graph illustrating performance in both encoding conditions of the item recognition portion of the Relational and Item Specific Encoding (RISE) task. Asterisk (*) significances are across participant groups while arrowhead (^) significances are within groups.

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Figure S3: Graph of mean accuracy scores across different jitter degree conditions of the Jittered Orientation Visual Integration (JOVI) task. Error bars are standard errors.

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