Cognitive dysfunctions in medicated and unmedicated patients with recent-onset schizophrenia (original) (raw)
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European Psychiatry, 2005
Forty-three patients with schizophrenia were investigated with a short neurocognitive screening battery focussing on working memory and executive functions. As compared to healthy controls, patients showed impairments in the modified card sorting test, in verbal fluency and all span tasks with exception of digit span forward. Patients who were treated with atypicals showed better performance in the digit ordering test (manipulation task) when compared to a group of patients who received conventional antipsychotics; this difference was not due to disease severity, age or education. Manipulation tasks might be useful for neurocognitive follow-up and intervention studies.
Indian Journal of Mental Health, 2019
Background: Cognitive deficits among patients with schizophrenia are now recognized as being widely prevalent and one of the most disabling aspects of the illness, as they are associated with poor functional outcomes. Psychotropic medications and benzodiazepines, which are often used in these patients could impact cognition as could the extrapyramidal side-effects. Yet, here are hardly any Indian studies on the subject. The aim of this study was to determine whether cognitive dysfunction among patients with schizophrenia is associated with extrapyramidal symptoms, anticholinergic burden of psychotropic drugs and benzodiazepine dosage Methodology: 40 clinically stable, outpatients suffering from schizophrenia, without any pre-existing neurological disorders between the ages of 18 to 60 years, who had been compliant with medications were selected. Extrapyramidal symptoms (EPS) were assessed using the modified Simpson-Angus scale, anticholinergic burden (ACB) was evaluated using the Anticholinergic burden scale. The benzodiazepine dosage was noted. Cognition was assessed using the Stroop Color and Word Test and the Wisconsin Card sorting test. The correlations between scores on EPS and ACB and neuropsychological tests were carried out using partial correlations controlling for positive and negative symptoms. Results: There were no significant associations noted between extrapyramidal symptoms, anticholinergic burden, benzodiazepine dosage and performance on the neurocognitive tests used. Conclusion: Methodological differences make it difficult to construct comparisons across studies but there is some evidence to support our findings.
Memory and attention deficits in drug naive patients with schizophrenia
Schizophrenia Research, 2001
The present study was designed to evaluate the integrity of cognitive fronto-temporal processes in drug naive patients with schizophrenia. The evaluation of drug naive patients discards the potential in¯uence of medication, and may allow the speci®cation of cognitive impairments that are truly illness-related. Subcomponents of long-term memory as well as several measures of attention were examined. A group of 16 patients who had never taken antipsychotics and a group of 20 normal controls underwent tests of alertness, information maintaining, and sustained and selective attention, as well as tests of explicit and implicit recall. The psychopathological manifestations of patients were also assessed with the BPRS, PANSS, ESRS clinical scales. Attention test performances revealed that drug naive patients presented a decrease in their ability to respond promptly to a stimulus, sustain their attention on a task, display normal selective attention strategies, and maintain information for on-line processing. The results also suggest that the drug naive patients are impaired when both strategic and associative processes must be triggered to explicitly recover information in long-term memory. In contrast, the results revealed that implicit access to perceptual mental representations is spared in schizophrenic patients. Finally, features of the patients' clinical symptomatology and some cognitive de®cits were also shown to be correlated. Overall, results showed that, in relation to normals, drug naive patients were mildly impaired, with little intersubject variability, and that not all cognitive processes were equally disturbed in relation to the normal subjects' performances. Results support the idea that an important part of the impairments seen in schizophrenia is present before the introduction of neuroleptic medication and chronic illness.
Antipsychotic medication and cognitive function in schizophrenia
Schizophrenia Research, 2006
Antipsychotic polypharmacy and excessive dosing still prevail worldwide in the treatment of schizophrenia, while their possible association with cognitive function has not well been examined. We examined whether the "non-standard" use of antipsychotics (defined as antipsychotic polypharmacy or dosage > 1000 mg/day of chlorpromazine equivalents) is associated with cognitive function. Furthermore, we compared cognitive function between patients taking only atypical antipsychotics and those taking only conventionals. Neurocognitive functions were assessed in 67 patients with chronic schizophrenia and 92 controls using the Wechsler Memory Scale-Revised (WMS-R), the Wechsler Adult Intelligence Scale-Revised (WAIS-R), the Wisconsin Card Sorting Test (WCST), and the Advanced Trail Making Test (ATMT). Patients showed markedly poorer performance than controls on all these tests. Patients on non-standard antipsychotic medication demonstrated poorer performance than those on standard medication on visual memory, delayed recall, performance IQ, and executive function. Patients taking atypical antipsychotics showed better performance than those taking conventionals on visual memory, delayed recall, and executive function. Clinical characteristics such as duration of medication, number of hospitalizations, and concomitant antiparkinsonian drugs were different between the treatment groups (both dichotomies of standard/non-standard and conventional/atypical). These results provide evidence for an association between antipsychotic medication and cognitive function. This association between antipsychotic medication and cognitive function may be due to differential illness severity (e.g., non-standard treatment for severely ill patients who have severe cognitive impairment). Alternatively, poorer cognitive function may be due in part to polypharmacy or excessive dosing. Further investigations are required to draw any conclusions.
Effect of Atypical Anti-psychotics on Cognition in Schizophrenia
NILES Journal forGeriatric and Gerontology/NILES Journal for Geriatric and Gerontology, 2024
Background: Schizophrenia is a chronic psychiatric disorder that affects mainly cognition and runs in chronic deteriorating course. Objective: The study aimed to assess the cognitive function of schizophrenic patients compared to healthy control and verify the effect of atypical anti-psychotics on cognition in schizophrenia. Patients & Methods: This case-control study included 3 groups, group 1: 20 newly diagnosed patients with schizophrenia, group 2: 20 schizophrenic patients receiving atypical antipsychotics and group 3: 20 control healthy persons. The participants of the three groups were subjected to clinical assessment, that included detailed psychiatric interview, neurological and general examination. Cognitive evaluation of both schizophrenic and control groups by, Wechsler Adult Intelligence Scale (WAIS), Wisconsin Card Sorting Test (WCST), stroop test (computerized version), the Trail Making test, continuous performance test and Wechsler Memory scale (WMS). Results: The schizophrenic patients had worse results than healthy control group in all neuropsychological tests: The Wechsler Adult Intelligence Scale (WAIS), The Wisconsin Card Sorting Test (WCST), Stroop Test, The Trail Making Test (TM,) Continuous performance test (CPT) and The Wechsler memory scale (WMS).The impairment was more in the newly diagnosed patients without treatment. Conclusions and clinical implications: Patients with schizophrenia suffered from cognitive impairment which mostly involved the different cognitive domains in different combinations, manifested least way in patients who received atypical antipsychotics.
First- and second-generation antipsychotic medication and cognitive processing in schizophrenia
Current psychiatry reports, 2005
Schizophrenia has been consistently characterized by deficits in the cognitive domains of executive function, working memory, attention, and episodic memory. Although some cognitive abnormalities, such as motor slowing, may be associated with antipsychotic medication administration, generally the cognitive deficits shown by patients with schizophrenia can be attributed at least in part to the disease process. Modulation of the dopamine neurotransmitter system, notably through D2 receptor blockade, has been associated with psychotic symptom reduction and cognitive performance improvements in patients with schizophrenia. Although first-generation antipsychotic medication treatment initially was thought not to result in cognitive improvement, recent studies comparing second-generation antipsychotics to low doses of first-generation antipsychotic medication showed cognitive benefits for first-generation drugs, although perhaps not as great as that found after treatment with second-gener...
Specific executive dysfunction in patients with first-episode medication-naïve schizophrenia
Schizophrenia Research, 2006
Many studies have shown that schizophrenia is associated with a wide range of cognitive impairments. Empirical findings suggest that patients with schizophrenia suffer from a bdysexecutive syndromeQ. However, the extent to which a general decline in neuropsychological function accounts for symptoms of executive dysfunction in schizophrenia is not clear. In this study, we examined further the nature and pattern of executive function in a sample of medication-naïve patients experiencing a firstepisode of schizophrenia with a set of tests capturing the specific components of executive function. We also compared the performance of this clinical group with healthy controls. A total of 78 medication-naïve patients with first episode schizophrenia were recruited from the Early Assessment Service for Young People with Psychosis (EASY). Another 60 healthy controls were recruited for comparison. All subjects participated in a comprehensive set of executive function tests assessing initiation, sustained attention, online updating, switching, attention allocation, inhibition, and non-executive function. The executive function of patients with first-episode schizophrenia was found to be compromised relative to healthy controls. However, unlike patients with established schizophrenia, first episode patients exhibited only a limited deficit in sustained attention. Moreover, the majority of executive function deficits did not correlate with intellectual functioning and memory impairment in a sub-group of first episode patients without intellectual impairment. These findings suggest that first-episode patients exhibit a specific pattern of executive dysfunction compared to healthy controls and patients with an established illness. This differential breakdown of executive function components is unlikely to be an artefact of general intellectual decline or memory impairment in schizophrenia. D
Neuropsychological profile of cognitively impaired patients with schizophrenia
Comprehensive Psychiatry, 2006
Objective: Our purpose in undertaking the present study was to explore the existence of specific areas of cognitive deficits within the context of generalized poor performance in a group of Greek patients with schizophrenia. We also sought to identify any patients who might be cognitively normal. Method: Participants were 70 patients with schizophrenia and 42 healthy control subjects. The 2 groups were matched on age and male-female ratio but differed in their level of education. A battery of neuropsychological tests was selected to assess executive functions/abstraction, fluency, verbal and spatial working memory, verbal and nonverbal memory, attention, visuospatial ability, and psychomotor speed. Results: Patients with schizophrenia performed more poorly than healthy control subjects, when we controlled for differences in level of education, on executive functions, working memory, verbal memory, nonverbal memory, fluency, visuospatial ability, and attention. In contrast, no significant differences were found between the 2 groups on psychomotor speed. Patients showed a more pronounced deficit on executive functions, verbal and visual memory, and visuospatial ability. Overall, 13% to 62% of the patients with schizophrenia scored within 1 SD of the mean z scores of healthy control group depending on the cognitive domains examined. In the entire sample of patients with schizophrenia, however, no individual scored within 1 SD of the mean z scores of the control group in all cognitive domains. Conclusions: We found a generalized deficit in cognitive functioning in a group of patients with schizophrenia. We failed to find any individual patients who were healthy across all cognitive areas. The current neuropsychological profile, indicating widespread impairment, is comparable to that reported in the international literature and thus appears to be characteristic of schizophrenia. Our findings of increased difficulties with executive functions, verbal and visual memory, and visuospatial ability support previous suggestions of generalized brain dysfunction in the pathophysiology of schizophrenia. D