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Schizophrenia with Good and Poor Outcome

III: Neurological ‘Soft’ Signs, Cognitive Impairment and their Clinical Significance

Published online by Cambridge University Press:  29 January 2018

T. Kolakowska ,
A. O. Williams ,
K. Jambor  and
M. Ardern
T. Kolakowska*
Affiliation:
Department of Psychiatry, University of Oxford, Littlemore Hospital, Oxford OX4 4XN
A. O. Williams
Affiliation:
Department of Psychiatry, University of Oxford, Littlemore Hospital, Oxford OX4 4XN
K. Jambor
Affiliation:
Littlemore Hospital, Oxford OX4 4XN
M. Ardern
Affiliation:
Department of Psychiatry, University of Oxford, Littlemore Hospital, Oxford OX4 4XN
*
∗Correspondence
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Summary

Fifty-six patients with RDC schizophrenia (42) or schizoaffective disorder (14), of two to 20 years' duration, were assessed for neurological ‘soft’ signs and cognitive impairment when in a stable condition—the ‘outcome’. Neurological dysfunction (46% of 50 examined patients) was associated with a history of developmental abnormalities, but was unrelated to outcome, psychiatric symptoms, or treatment. Deficits in particular cognitive fields were related to two independent factors: overall severity of residual psychiatric disorder (outcome) and neurological dysfunction. There was no relationship between the size of the lateral brain ventricles on CT scan and either ‘soft’ signs or cognitive impairment.

The findings do not provide evidence for an association between the presence of organic brain disorder (as indicated by the joint occurrence of neurological dysfunction and cognitive impairment) and either poor outcome or particular symptoms of schizophrenia.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 146 , Issue 4 , April 1985 , pp. 348 - 357
Copyright
Copyright © 1985 The Royal College of Psychiatrists 

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References

Abrams, R., Redfield, J. & Taylor, M. A. (1981) Cognitive dysfunction in schizophrenia, affective disorder and organic brain disease. British Journal of Psychiatry, 139, 190–194.Google Scholar
Annett, M. (1970) A classification of hand-preference by association analysis. British Journal of Psychology, 61, 303–321.Google Scholar
Bellak, L. & Charles, E. (1979) Schizophrenic syndrome related to minimal brain dysfunction: A possible neurological subgroup. Schizophrenia Bulletin, 5, 480–489.Google Scholar
Cox, S. M. & Ludwig, A. M. (1979) Neurological soft signs and psychopathology. I. Findings in schizophrenia. Journal of Nervous and Mental Disease, 167, 161–165.Google Scholar
de Wolfe, A. S., Barrell, R. P., Becker, B. C. & Spaner, F. E. (1971) Intellectual deficit in chronic schizophrenia and brain damage. Journal of Consulting and Clinical Psychology, 36, 197–204.Google Scholar
Donnelly, E. F., Weinberger, D. R., Waldman, I. N. & Wyatt, R. J. (1980) Cognitive impairment associted with morphological brain abnormalities on computed tomography in chronic schizophrenic patients. Journal of Nervous and Mental Diseases, 168, 305–308.Google Scholar
Erlenmayer-Kimling, L. Cornblatt, B., Friedman, D., Mareuse, Y., Rutschmann, J., Simmens, S. & Devi, S. (1982) Neurological electrophysiological and attentional deviations in children at risk for schizophrenia. In Schizophrenia as a Brain Disease (eds. Henn, F. A. & Nasrallah, H. A.). New York, Oxford University Press.Google Scholar
Famuyiwa, O. O., Eccleston, D., Donaldson, A. A. & Garside, R. F. (1979) Tardive dyskinesia and dementia. British Journal of Psychiatry, 135, 500–504.Google Scholar
Golden, C. J., Moses, J. A., Zelazowski, R, Graber, B., Matz, L. M., Horvath, T. B. & Berger, P. A. (1980) Cerebral ventricular size and neuropsychological impairment in young chronic schizophrenics. Archives of General Psychiatry, 37, 619–623.CrossRefGoogle ScholarPubMed
Golden, C. J., Carpenter, B., Wilkening, G., Ruedrich, S., Chu, C. & Grater, B. (1983) The relationship of the Brief Psychiatric Rating Scale to neuropsychological deficits in phenothiazine-treated schizophrenics. Psychopharmacology Bulletin, 19, 513–517.Google Scholar
Goldstein, G. (1978) Cognitive and perceptual differences between schizophrenia and organics. Schizophrenia Bulletin, 4, (2), 160–185.Google Scholar
Guy, W. (1973) ECDEU Assessment Manual for Psychopharmacology, Bethesda, Maryland: U. S. Department of Health, Education and Welfare.Google Scholar
Hamilton, V. (1963) 10 changes in chronic schizophrenics. British Journal of Psychiatry, 109, 642–648.CrossRefGoogle Scholar
Haywood, H. C. & Moelis, D. (1963) Effect of symptom change on intellectual function in schizophrenia. Journal of Abnormal and Social Psychology, 67, 76–78.CrossRefGoogle ScholarPubMed
Heaton, R. K., Baade, L. E. & Johnson, K. L. (1978) Neuropsychological test results associated with psychiatric disorders in adults. Psychological Bulletin, 85, 141–162.CrossRefGoogle ScholarPubMed
Higgins, J. (1969) Process-reactive schizophrenia. Journal of Nervous and Mental Diseases, 149, 450–472.Google Scholar
Howard, M. L., Hogan, T. P. & Wright, M. W. (1975) The effects of drugs on psychiatric patients' performance on the Halstead-Reitan neuropsychological test battery. Journal of Nervous and Mental Diseases, 161, 166–171.Google Scholar
Huey, L. Y., Zetin, M., Janovsky, D. S. & Judd, L. J. (1978) Adult minimal brain dysfunction and schizophrenics: A case report. American Journal of Psychiatry, 135, 1563–1565.Google Scholar
Jambor, K. L. (1969) Cognitive function in muiltiple sclerosis. British Journal of Psychiatry, 115, 765–775.CrossRefGoogle Scholar
Johnstone, E. C., Crow, T. J., Frith, C. D., Stevens, M. Kreel, L. & Husband, J. (1978) The dementia of dementia praecox. Acta Psychiatrica Scandinavica, 57, 305–324.Google Scholar
Kennard, M. A. (1960) Value of equivocal signs in neurologic diagnosis. Neurology, 10, 753–764.Google Scholar
Klonoff, H., Fibiger, C. H. & Hutton, G. H. (1970) Neuropsychological patterns in chronic schizophrenia. Journal of Nervous and Mental Diseases, 150, 291–300.CrossRefGoogle ScholarPubMed
Kolakowska, T., Williams, A. O. Ardern, M., Reveley, M. A., Jambor, K., Gelder, M. G. & Mandelbrote, B. M. (1985) Schizophrenia with a good and poor outcome. I. Early clinical features, response to neuroleptics and signs of organic dysfunction. British Journal of Psychiatry, 146, 229–239.Google Scholar
Lezak, M. D. (1976) Neuropsychological Assessment. New York, Oxford University Press, pp. 321–323.Google Scholar
Lilliston, L. (1973) Schzophrenic symptomatology as a function of probability of cerebral damage. Journal of Abnormal Psychology, 32, 377–381.CrossRefGoogle Scholar
Malec, J. (1978) Neuropsychological assessment of schizophrenic versus brain damage: A review. Journal of Nervous and Mental Diseases, 166, 507–516.CrossRefGoogle Scholar
Mosher, L., Pollin, W. & Stabenau, J. (1971) Identical twins discordant for schizophrenia. Archives of General Psychiatry, 24, 422–430.Google Scholar
Nasrallah, H. A., Tippin, J. & McCalley-Whitters, M. (1982) Neurological soft signs in manic patients: A comparison with schizophrenics and control groups. Journal of Clinical Psychiatry, 43, 310–312.Google Scholar
Nelson, H. E. & O'Connell, A. D. (1978) Dementia: The estimation of premorbid intelligence levels using the New Reading Test. Cortex, 14, 234–244.CrossRefGoogle Scholar
Oltmanns, T. F., Ohayon, J. & Neale, J. M. (1978) The effect of antipsychotic medication and diagnostic criteria on distractability in schizophrenics. In The Nature of Schizophrenia: New approaches to research and treatment”. New York, John Willey & Sons Inc., pp. 283–286.Google Scholar
Overall, G. E. & Gorham, D. R. (1962) The brief psychiatric rating scale. Psychological Reports, 10, 799–812.Google Scholar
Owens, D. G. C. & Johnstone, E. C. (1980) The disabilities of chronic schizophrenia: Their nature and factors contributing to their development. British Journal of Psychiatry, 136, 384–395.Google Scholar
Quitkin, F., Rifkin, A, & Klein, D. F. (1976) Neurological soft signs in schizophrenia and character disorders: Organicity in schizophrenia with premorbid asociality and emotionally unstable character disorders. Archives of General Psychiatry, 33, 845–853.Google Scholar
Rieder, R. O., Donnelly, E. F., Herdt, J. R. & Walderman, I. N. (1979) Sulcal prominence in young chronic schizophrenic patients: CT scan findings associated with impairment on neuropsychological tests. Psychiatry Research, 1, 1–8.Google Scholar
Rochford, J. M., Detre, T., Tucker, G. J. & Harrow, M. (1970) Neuropsychological impairments in functional psychiatric diseases. Archives of General Psychiatry, 22, 114–119.Google Scholar
Simpson, G. H. & Angus, J. W. S. (1970) A rating scale for extrapyramidal side-effects. Acta Psychiatrica Scandinavica Supplement. 212, 11–19.Google Scholar
Smith, A. (1964) Mental deterioration in chronic schizophrenia. Journal of Nervous and Mental Diseases, 139, 479–487.Google Scholar
Smith, R. C., Largen, J., Calderon, M., Schoolar, J., Shvartsburd, A. & Ravichandran, G. K. (1983) Morphological and neuropsychological abnormalities as predictors of clinical response to psychotropic drugs. Psychopharmacology Bulletin, 19, 505–509.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1975) Research Diagnostic Criteria. N. Y. State Department of Mental Hygiene, N. Y. State Psychiatric Institute, Biometrie Research.Google Scholar
Stuve, F. A. & Willner, A. E. (1983) Cognitive dysfunction and tardive dyskinesia. British Journal of Psychiatry, 143, 597–600.CrossRefGoogle Scholar
Torrey, E. F. (1980) Neurological abnormalities in schizophrenic patients. Biological Psychiatry, 15 (3), 381–388.Google Scholar
Tucker, G. J., Campion, E. W. & Silberfarb, P. M. (1975) Sensorimotor functions and cognitive disturbance in psychiatric patients. American Journal of Psychiatry, 132, 17–21.Google Scholar
Warrington, E. K. & Taylor, A. M. (1973) The contribution of the right parietal lobe to object recognition. Cortex, 9, 152–164.Google Scholar
Warrington, E. K. (1974) Deficient recognition memory in organic amnesia. Cortex, 10, 289–291.Google Scholar
Watson, C. G. (1965) WAIS profile patterns of hospitalized brain-damaged and schizophrenic patients. Journal of Consulting and Clinical Psychology, 21, 294–295.Google Scholar
Wells, C. E. & Duncan, G. W. (1980) Neurology for Psychiatrists. F. N. Davis, Philadelphia.Google Scholar
Williams, A. O., Reveley, M. A., Kolakowska, T., Ardern, M. & Mandelbrote, B. M. (1985) Schizophrenia with good and poor outcome. II. Cerebral ventricular size and its clinical significance. British Journal of Psychiatry, 146, 239–246.Google Scholar
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