Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-22T07:36:55.477Z Has data issue: false hasContentIssue false
  • English
  • Français

Executive (frontal) dysfunction and negative symptoms in schizophrenia: Apparent gender differences in ‘static’ v. ‘progressive’ profiles

Published online by Cambridge University Press:  03 January 2018

Paul J. Scully ,
Grainne Coakley ,
Anthony Kinsella  and
John L. Waddington
Paul J. Scully
Affiliation:
Stanley Foundation Research Unit, St Davnet's Hospital, Monaghan, and Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin
Grainne Coakley
Affiliation:
Stanley Foundation Research Unit, St Davnet's Hospital, Monaghan
Anthony Kinsella
Affiliation:
Department of Mathematics, Dublin Institute of Technology
John L. Waddington*
Affiliation:
Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin, Ireland
*
Professor John L. Waddington, Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2. Ireland. Fax: (353) (+) 402 2453
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

While executive (frontal lobe) dysfunction appears to be a core feature of schizophrenia, its relationship to psychopathology, age and duration of illness has yet to be explored systematically between the genders.

Method

Executive dysfunction, positive and negative symptoms were evaluated in 27 male and 21 female in-patients who were unusually well-matched on numerous demographic and clinical measures.

Results

Measures of executive dyscontrol and negative symptoms were highly associated in both genders. However, while both executive dyscontrol and negative symptoms increased prominently with age/duration of illness among women, no such relationship was evident among men.

Conclusions

The similarly prominent levels of current executive dyscontrol and negative symptoms in male and female patients appear to have emerged via processes that differ fundamentally between the genders; among males these deficits appear to emerge and become ‘locked in’ earlier in the course of illness and to show little subsequent increase, while among females these same deficits appear to be less evident early in the course but to increase in prominence thereafter.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 2 , August 1997 , pp. 154 - 158
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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

REFERENCES

Andia, A. M., Zisook, S., Heaton, R. K., at al (1995) Gender differences in Schizophrenia. Journal of Nervous and Mental Disease, 183, 522–528.Google Scholar
Arnold, S. E., Gur, R. E., Shapiro, R. M., at al (1995) Prospective clinicopathologic studies of schizophrenia. American Journal of Psychiatry, 152, 731–737.Google ScholarPubMed
Beiser, M., Erickson, D., Fleming, J. A., et al (1993) Establishing the onset of psychotic illness. American Journal of Psychiatry, 150, 1349–1354.Google Scholar
Bilder, R. M., Lipschutz-Broch, L., Reiter, G., et al (1992) Intellectual deficits in first-episode schizophrenia: evidence for progressive deterioration. Schizophrenia Bulletin, 18, 437–448.Google Scholar
Blanchard, J. J. & Neale, J. M. (1994) The neuropsychological signature of schizophrenia: generalised or differential deficit? American Journal of Psychiatry, 151, 40–48.Google Scholar
Breier, A., Schreiber, J. L., Dyer, J., et al (1991) National Institute of Mental Health longitudinal study of chronic schizophrenia. Archives of General Psychiatry, 48, 239–246.Google Scholar
Buhrich, N., Crow, T. J., Johnstone, E. C., et el (1988) Age disorientation in chronic schizophrenia is not associated with pre-morbid intellectual impairment or past physical treatment. British Journal of Psychiatry, 152, 466–469.CrossRefGoogle ScholarPubMed
Castle, D. J., Wessely, S. & Murray, R. M. (1993) Sex and schizophrenia: effects of diagnostic stringency, and associations with premorbid variables. British Journal of Psychiatry, 162, 658–664.CrossRefGoogle ScholarPubMed
Chen, E. Y. H., Lam, L. C. W. & Nguyen, D. G. H. (1996a) Negative symptoms, neurological signs and neuropsychological impairments in 204 Hong Kong Chinese patients with schizophrenia. British Journal of Psychiatry, 168, 227–233.Google Scholar
Chen, E. Y. H., Lam, L. C. W., Chen, R. Y. L., et al (1996b) Prefrontal neuropsychological impairment and illness duration in schizophrenia: a study of 204 patients in Hong Kong. Acta Psychiatrica Scandinavica, 93, 144–150.Google Scholar
Cuesta, M. J., Peralta, V. & De Leon, J. D. (1996) Neurological frontal signs and neuropsychological deficits in schizophrenic patients. Schizophrenia Research, 20, 15–20.Google Scholar
Davidson, M., Harvey, P D., Powchik, P., et al (1995) Severity of symptoms in chronically institutionalized geriatric schizophrenic patients. American Journal of Psychiatry, 152, 197–207.Google Scholar
Davis, J. M. (1976) Comparative doses and costs of antipsychotic medication. Archives of General Psychiatry, 33, 858–861.Google Scholar
Elliott, R., McKenna, R. J., Robbins, T. W., et al (1995) Neuropsychological evidence for frontostriatal dysfunction in schizophrenia. Psychological Medicine, 25, 619–630.Google Scholar
Faraone, S. F., Chen, W. J., Goldstein, J. M., et al (1994) Gender differences in age at onset of schizophrenia. British Journal of Psychiatry, 164, 625–629.Google Scholar
Feighner, J. P., Robins, E., Guze, S. B., et al (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Frith, C. (1995) Schizophrenia: functional imaging and cognitive abnormalities. Lancet, 346, 615–620.Google Scholar
Goldberg, T. E., Hyde, T. M., Kleinman, J. E., et al (1993) Course of schizophrenia: neuropsychological evidence for a static encephalopathy. Schizophrenia Bulletin, 19, 797–804.CrossRefGoogle ScholarPubMed
Goldberg, T. E. & Gold, J. M. (1995) Neurocognitive deficits in schizophrenia. In Schizophrenia (eds S. R. Hirsh & D. R. Weinberger), pp. 146–162. Oxford: Blackwell.Google Scholar
Goldberg, T. E. & Gold, J. M., Torrey, E. F., et al (1995) Lack of sex differences in the neuropsychological performance of patients with schizophrenia. American Journal of Psychiatry, 152, 883–888.Google Scholar
Goldstein, G., Zubin, J. & Pogue-Geile, M. F. (1991) Hospitalization and the cognitive deficits of schizophrenia: the influences of age and education. Journal of Nervous and Mental Disease, 179, 202–206.CrossRefGoogle ScholarPubMed
Goldstein, J. M. (1993) Sampling biases in studies of gender and schizophrenia: a reply. Schizophrenia Bulletin, 19, 9–14.Google Scholar
Goldstein, J. M. & Link, B. G. (1988) Gender and the expression of schizophrenia. Journal of Psychiatric Research, 22, 141–155.Google Scholar
Goldstein, J. M., Seidman, L. J., Santangelo, S., et al (1994) Are schizophrenic men at higher risk for developmental deficits than schizophrenic women? Implications for adult neuropsychological functions. Journal of Psychiatric Research, 28, 483–498.CrossRefGoogle ScholarPubMed
Hammer, M. A., Katsanis, J. & Iacono, W. G. (1995) The relationship between negative symptoms and neuropsychological performance. Biological Psychiatry, 37, 828–830.CrossRefGoogle ScholarPubMed
Heaton, R., Paulsen, J. S., McAdams, L. A., et al (1994) Neuropsychological deficits in schizophrenics. Archives of General Psychiatry, 51, 469–476.CrossRefGoogle ScholarPubMed
Hoff, A. L., Riordan, H., O'Donnell, D. W., et al (1992) Neuropsychological functioning in first episode schizophreniform patients. American Journal of Psychiatry, 149, 898–903.Google Scholar
Kay, S. R. (1991) Positive and Negative Syndromes in Schizophrenia. New York: Brunner/Mazel.Google Scholar
Kay, S. R., Fiszbein, A. & Opler, L. A. (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261–276.CrossRefGoogle ScholarPubMed
Kendler, K. S. & Walsh, D. (1995) Gender and schizophrenia: results of an epidemiologically-based family study. British Journal of Psychiatry, 167, 184–192.CrossRefGoogle ScholarPubMed
Lewis, S. W. (1992) Sex and schizophrenia. British Journal of Psychiatry, 161, 445–450.Google Scholar
Liddle, P. F. & Morris, D. L. (1991) Schizophrenic syndromes and frontal lobe performance. British Journal of Psychiatry, 158, 340–345.CrossRefGoogle ScholarPubMed
Merriam, A. E., Stanley, R. K., Opler, L. A., et al (1990) Neurological signs and the positive-negative dimension in schizophrenia. Biological Psychiatry, 28, 181–192.CrossRefGoogle ScholarPubMed
Morice, R. & Delahunty, A. (1996) Frontal/executive impairments in schizophrenia. Schizophrenia Bulletin, 22, 125–137.CrossRefGoogle ScholarPubMed
Mortimer, A. & McKenna, P. J. (1994) Levels of explanation – symptoms, neuropsychological deficit and morphological abnormalities in schizophrenia. Psychological Medicine, 24, 541–545.Google Scholar
Perlick, D., Mattis, S., Stastny, P., et al (1992) Gender differences in cognition in schizophrenia. Schizophrenia Research, 8, 69–73.Google Scholar
Ring, N., Tantam, D., Montague, L., et al (1991) Negative symptoms in chronic schizophrenia: relationship to duration of illness. British Journal of Psychiatry, 159, 495–499.CrossRefGoogle ScholarPubMed
Royall, D. R., Mahurin, R. K. & Gray, K. F. (1992) Bedside assessment of executive cognitive impairment: the Executive Interview. Journal of the American Geriatrics Society, 40, 1221–1226.Google Scholar
Royall, D. R., Mahurin, R. K., True, J. E., et al (1993) Executive impairment among the functionally dependent: comparisons between schizophrenic and elderly subjects. American Journal of Psychiatry, 150, 1813–1819.Google Scholar
Saykin, A. J., Gur, R. C., Gur, R. E., et al (1991) Neuropsychological function in schizophrenia: selective impairment in memory and learning. Archives of General Psychiatry, 48, 618–624.CrossRefGoogle ScholarPubMed
Saykin, A. J., Shtasel, D. L., Gur, R. E., et al (1994) Neuropsychological deficits in neuroleptic-naive patients with first episode schizophrenia. Archives of General Psychiatry, 51, 124–131.Google Scholar
Scully, P. J., Coakley, G., Kinsella, A., et al (1996) Psychopathology and cognitive (executive) dysfunction in relation to duration of initially untreated psychosis in schizophrenia. European Psychiatry, 11 (suppl. 4), 280–281.Google Scholar
Waddington, J. L. (1993a) Schizophrenia: developmental neuroscience and pathobiology. Loncet, 341, 531–536.Google Scholar
Waddington, J. L. (1993b) Neurodynamics of abnormalities in cerebral metabolism and structure in schizophrenia. Schizophrenia Bulletin, 19, 55–69.Google Scholar
Waddington, J. L., Youssef, H. A., Dolphin, C., et al (1987) Cognitive dysfunction, negative symptoms and tardive dyskinesia in schizophrenia. Archives of General Psychiatry, 44, 907–912.Google Scholar
Waddington, J. L., Youssef, H. A. & Kinsella, A. (1990) Cognitive dysfunction in schizophrenia followed up over 5 years, and its longitudinal relationship to the emergence of tardive dyskinesia. Psychological Medicine, 20, 835–842.Google Scholar
Waddington, J. L., Youssef, H. A. & Kinsella, A. (1995) Sequential cross-sectional and 10-year prospective study of severe negative symptoms in relation to duration of initially untreated psychosis in chronic schizophrenia. Psychological Medicine, 25, 849–857.Google Scholar
Waddington, J. L. & Buckley, P. F. (1996) The Neurodevelopmental Basis of Schizophrenia. Austin, TX: Landes.Google Scholar
Waddington, J. L. & Youssef, H. A. (1996) Cognitive dysfunction in chronic schizophrenia followed prospectively over 10 years and its longitudinal relationship to the emergence of tardive dyskinesia. Psychological Medicine, 26, 681–688.Google Scholar
Waddington, J. L., Scully, P. J. & Youssef, H. A. (1997) Developmental trajectory and disease progression in schizophrenia: the conundrum, and insights from a 12-year prospective study in the Monaghan 101. Schizophrenia Research, 23, 107–118.Google Scholar
Weinberger, D. R. (1987) Implications of normal brain development for the pathogenesis of schizophrenia. Archives of General Psychiatry, 44, 660–669.CrossRefGoogle ScholarPubMed
Weinberger, D. R. (1995) Schizophrenia: from neuropathology to neurodevelopment. Lancet, 346, 552–557.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.