Neurocognitive Deficit in Patients with Schizophrenic Spectrum Disorders
https://doi.org/10.30629/2618-6667-2022-20-1-67-75
Abstract
Background: cognitive disorders are considered as key disfunctions in schizophrenia spectrum disorders and as risk factors of schizophrenia.
The aim of study was to examine neurocognitive deficit in patients with schizophrenic spectrum disorders, its structure and risk factors of schizophrenia.
Patients and methods: 42 patients were examined with the diagnosis of “schizotypal disorder” (F21.3–21.5 according to ICD-10, n = 20) and “paranoid schizophrenia” (F20.00 according to ICD-10, n = 22). The control group included 20 people who had no signs of mental disorder. Cross-sectional study used methods for cognitive functions assessment.
Results: patients with schizotypal disorder and paranoid schizophrenia are united by a deficit in the speed of processing, in verbal, visual and working memory, executive functions with sufficiently preserved visual-constructive abilities. In patients with the schizotypal disorder, compared with patients with paranoid schizophrenia, sustained attention and taskswitching ability, the effectiveness of long-term memorization and visual-spatial abilities are preserved to a greater extent. We found a correlation between burdened heredity and reduced results of the “Ray–Osterritz figure” technique and between the frequency of seeking medical help and the indicator of the “TMT-B” tracking test. Patients with schizotypal disorder are more likely to received more than one antipsychotic. The cognitive functioning of patients taking first/second generation antipsychotic drugs or their combination does not differ.
Conclusions: patients with schizotypal disorder show similar, but in contrast to patients with paranoid schizophrenia, less pronounced cognitive impairment. There is a link between the degree of visual-spatial ability and the family risk of psychosis. The frequency of seeking medical help (unfavorable course of the disease) is associated with task-switching ability. Antipsychotic polypharmacotherapy, subject to dosages, is not a significant factor in cognitive disorders.
About the Authors
N. N. PetrovaRussian Federation
Nataliia N. Petrova, Dr. of Sci. (Med.), Professor, Head of Psychiatry and Narcology Department
Saint Petersburg
V. V. Mararitsa
Russian Federation
Valeria V. Mararitsa, Resident, Psychiatry and Narcology Department
Saint Petersburg
References
1. Breier A. Cognitive deficit in schizophrenia and its neurochemical basis. Br J Psychiatry Suppl. 1999;37:16–18.
2. Kahn RS, Keefe RS. Schizophrenia is a cognitive illness: time for a change in focus. JAMA Psychiatry. 2013;70(10):1107–1112. DOI: 10.f1001/jamapsychiatry.2013.155
3. Greenwood TA, Shutes-David A, Tsuang DW. Endophenotypes in Schizophrenia: Digging Deeper to Identify Genetic Mechanisms. J Psychiatr Brain Sci. 2019;4(2):e190005. DOI: 10.20900/jpbs.20190005
4. Sheffield JM, Karcher NR, Barch DM. Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective. Neuropsychol Rev. 2018;28(4):509–533. DOI: 10.1007/s11065-018-9388-2 Epub 2018 Oct 20.
5. Bowie CR, Leung WW, Reichenberg A, McClure MM, Patterson TL, Heaton RK, Harvey PD. Predicting schizophrenia patients’ real-world behavior with specific neuropsychological and functional capacity measures. Biol Psychiatry. 2008;63(5):505–511. DOI: 10.1016/j.biopsych.2007.05.022
6. Milev P, Ho BC, Arndt S, Andreasen NC. Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudinal first-episode study with 7-year follow-up. Am J Psychiatry. 2005;162(3):495–506. DOI: 10.1176/appi.ajp.162.3.495
7. Kotsyubinsky AP. Autochthonous nonpsychotic disorders. St. Petersburg: SpetsLit, 2015:495 p. (In Russ.).
8. Shmukler AB, Syunyakov TB. Cognitive disorders in patients with schizophrenia. Sovremennaya terapiya psihicheskih rasstrojstv. 2018;4:8–17. (In Russ.). DOI: 10.21265/PSYPH.2018.47.21772
9. Dorofeikova MV, Petrova NN. Disorders of cognitive functions in schizophrenia and their correction. Sovremennaya terapiya psihicheskih rasstrojstv. 2015;1:2–9. (In Russ.).
10. Dorofeikova M, Neznanov N, Petrova N. Cognitive deficit in patients with paranoid schizophrenia: Its clinical and laboratory correlates. Psychiatry Research. 2018;262:542–548. DOI: 10.1016/j.psychres.2017.09.041
11. Lenzenweger MF. Schizotypy, schizotypic psychopathology and schizophrenia. World Psychiatry. 2018;17(1):25–26. DOI: 10.1002/wps.20479
12. Siever LJ, Davis KL. The pathophysiology of schizophrenia disorders: perspectives from the spectrum. Am J Psychiatry. 2004;161(3):398–413. DOI: 10.1176/appi.ajp.161.3.398 PMID: 14992962
13. Kirenskaya AB, Storozheva ZI, Tkachenko AA. Neurophysiological endophenotypes of schizophrenia as a tool for studying attention and behavior control: prospects for research and diagnosis. Saint Petersburg: Nestor-Istoriya, 2015:336 p. (In Russ.). ISBN 978-5-4469-0668-0
14. Elie D, Poirier M, Chianetta J, Durand M, Grégoire C, Grignon S. Cognitive effects of antipsychotic dosage and polypharmacy: a study with the BACS in patients with schizophrenia and schizoaffective disorder. J Psychopharmacol. 2010;24(7):1037–1044. DOI: 10.1177/0269881108100777 Epub 2009 Jan 22. PMID: 19164494
15. Aydın E, Cansu Ülgen M, Tabo A, Devrim Balaban Ö, Yeşilyurt S, Yumrukçal H. Executive function and genetic loading in nonpsychotic relatives of schizophrenia patients. Psychiatry Res. 2017;248:105–110. DOI: 10.1016/j.psychres.2016.12.027 Epub 2016 Dec 21. PMID: 28038438
16. Kim D, Kim JW, Koo TH, Yun HR, Won SH. Shared and distinct neurocognitive endophenotypes of schizophrenia and psychotic bipolar disorder. Clin Psychopharmacol Neurosci. 2015;13(1):94–102. DOI: 10.9758/cpn.2015.13.1.94
17. Siddi S, Petretto DR, Preti A. Neuropsychological correlates of schizotypy: a systematic review and meta-analysis of cross-sectional studies. Cogn Neuropsychiatry. 2017;22(3):186–212. DOI: 10.1080/13546805.2017.1299702 Epub 2017 Mar 13. PMID: 28288547
18. Dickinson D, Ramsey ME, Gold JM. Overlooking the obvious: a meta-analytic comparison of digit symbol coding tasks and other cognitive measures in schizophrenia. Arch Gen Psychiatry. 2007;64(5):532–542. DOI: 10.1001/archpsyc.64.5.532 PMID: 17485605
19. Knowles EE, Weiser M, David AS, Glahn DC, Davidson M, Reichenberg A. The puzzle of processing speed, memory, and executive function impairments in schizophrenia: fitting the pieces together. Biol Psychiatry. 2015;78(11):786–793. DOI: 10.1016/j.biopsych.2015.01.018
20. Keefe RS, Harvey PD. Understanding symbol coding in schizophrenia. Biol Psychiatry. 2015;78(11):744– 746. DOI: 10.1016/j.biopsych.2015.09.005 PMID: 26542742
21. Pukrop R, Ruhrmann S, Schultze-Lutter F, Bechdolf A, Brockhaus-Dumke A, Klosterkötter J. Neurocognitive indicators for a conversion to psychosis: comparison of patients in a potentially initial prodromal state who did or did not convert to a psychosis. Schi zophr Res. 2007;92(1–3):116–125. DOI: 10.1016/j.schres.2007.01.020 Epub 2007 Mar 6. PMID: 17344028
22. Seidman LJ, Giuliano AJ, Meyer EC, Addington J, Cadenhead KS, Cannon TD, McGlashan TH, Perkins DO, Tsuang MT, Walker EF, Woods SW, Bearden CE, Christensen BK, Hawkins K, Heaton R, Keefe RS, Heinssen R, Cornblatt BA; North American Prodrome Longitudinal Study (NAPLS) Group. Neuropsychology of the prodrome to psychosis in the NAPLS consortium: relationship to family history and conversion to psychosis. Arch Gen Psychiatry. 2010;67(6):578–588. DOI: 10.1001/archgenpsychiatry.2010.66 PMID: 20530007; PMCID: PMC3332118
23. Rosell DR, Futterman SE, McMaster A, Siever LJ. Schizotypal personality disorder: a current review. Curr Psychiatry Rep. 2014;16(7):452. DOI: 10.1007/s11920-014-0452-1 PMID: 24828284; PMCID: PMC4182925
24. Laere E, Tee SF, Tang PY. Assessment of Cognition in Schizophrenia Using Trail Making Test: A Meta-Analysis. Psychiatry Investig. 2018;15(10):945–955. DOI: 10.30773/pi2018.07.22 Epub 2018 Sep 19. PMID: 30223641; PMCID: PMC6212701
25. Petrova NN, Dorofeikova MV. Antipsychotic polypragmasia: pros and cons. Sovremennaya terapiya psihicheskih rasstrojstv. 2016;(1):11–17. (In Russ.).
26. Petrova NN. On the question of combined therapy of schizophrenia. Sovremennaya terapiya psihicheskih rasstrojstv. 2020;(2):12–18. (In Russ.). DOI: 10.21265/PSYPH.2020.10.43.002
Review
For citations:
Petrova N.N., Mararitsa V.V. Neurocognitive Deficit in Patients with Schizophrenic Spectrum Disorders. Psychiatry (Moscow) (Psikhiatriya). 2022;20(1):67-75. (In Russ.) https://doi.org/10.30629/2618-6667-2022-20-1-67-75