General and specific cognitive deficits in schizophrenia

doi:10.1016/j.biopsych.2003.12.010

Biological Psychiatry

Volume 55, Issue 8, 15 April 2004, Pages 826-833

https://doi.org/10.1016/j.biopsych.2003.12.010 Get rights and content

Abstract

Background

It is controversial whether the cognitive deficit in schizophrenia is better characterized as generalized or as reflecting relatively independent deficits in different cognitive domains. The issue has implications for assessment practice, intervention design, and the exploration of schizophrenia genetics.

Methods

We used a specialized structural equation modeling approach, single common factor analysis, to explore the relative importance of generalized versus independent cognitive deficits in schizophrenia. Eighteen subtest scores from the Wechsler Adult Intelligence Scale-III and the Wechsler Memory Scale-III were included in the analysis. We analyzed these data for 97 schizophrenia or schizoaffective disorder outpatients and 87 healthy control subjects.

Results

Approximately two thirds of the overall effect of a schizophrenia diagnosis on cognitive performance was mediated through a single common factor. The Wechsler subtest scores showed almost uniformly strong relationships with this factor. The independent associations of group status with the subtest scores were smaller in magnitude and only selectively significant.

Conclusions

The relatively greater magnitude of illness effects mediated through the common factor in this analysis, compared with the specific, independent effects, suggests that a generalized cognitive deficit is a core feature of schizophrenia.

Section snippets

Participants

The patient sample comprised 97 clinically stable outpatients (74 male, 23 female) who participated in studies at the Maryland Psychiatric Research Center (MPRC). All were recruited pursuant to procedures approved by the University of Maryland at Baltimore Institutional Review Board, and all gave written informed consent before participation in the study. Seventy of these patients were Caucasian, 26 were African American, and 1 was Asian. All patients met DSM-IV criteria for schizophrenia (n =

Results

Mean full-scale intelligence quotient was significantly impaired in the schizophrenia group, which performed approximately 1 SD below the level of the control group (see Table 2). Significant differences between groups were found for all of the Wechsler subtests but one. Consistent with past findings (Allen et al., 1998, Dickinson and Coursey, 2002, Gold et al., 1995), subtests loading on verbal comprehension and perceptual organization indexes were better preserved in the schizophrenia group,

Discussion

Schizophrenia is reliably associated with substantial impairment in cognitive test performance (Heinrichs and Zakzanis 1998). In the present analysis, a schizophrenia diagnosis alone accounted for 47% of the variance in performance across a large number of cognitive ability tests. The SCFA indicated that 65% of this diagnosis-related difference in cognitive performance (i.e., 30.5% of the total sample variance in cognitive performance) was mediated through a common factor. In other words,

Acknowledgements

This work was supported by a Department of Veterans Affairs, Health Services Research and Development Service, Associate Investigator's Training Award (DD), and by National Institute of Mental Health Grant MH57749 (JMG).

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Original articleGeneral and specific cognitive deficits in schizophrenia

Abstract

Background

Methods

Results

Conclusions

Section snippets

Participants

Results

Discussion

Acknowledgements

Cogn Dev

Schizophr Res

Biol Psychiatry

Biol Psychiatry

Schizophr Res

Am J Hum Genet

Neurobiol Aging

Trends Cogn Sci

Schizophr Res

Schizophr Res

Biol Psychiatry

Biol Psychiatry

Schizophr Res

Schizophr Res

Intelligence

Intelligence

Intelligence

Schizophr Res

Learning Individual Differences

Intelligence

A unitary model of schizophrenia

Arch Gen Psychiatry

Neuropsychological test performance in the acquired immunodeficiency syndromeIndependent effects of diagnostic group on functioning

J Int Neuropsychol Soc

Cognitive rehabilitation for schizophreniaProblems, prospects, and strategies

Schizophr Bull

Neuropsychology of first-episode schizophreniaInitial characterization and clinical correlates

Am J Psychiatry

The neuropsychological signature of schizophreniaGeneralized or differential deficit?

Am J Psychiatry

The generalized pattern of neuropsychological deficits in outpatients with chronic schizophrenia with heterogeneous Wisconsin Card Sorting Test results

Arch Gen Psychiatry

Original article
General and specific cognitive deficits in schizophrenia