[Neuropsychological deficits in the initial acute episode of schizophrenia. A comparison with chronic schizophrenic patients]. / Neuropsychologische Defizite bei ersterkrankten schizophrenen Patienten. Vergleich zu chronisch schizophrenen Patienten.

By administering an extensive battery of neuropsychological tests, cognitive performance of 66 patients with first episode schizophrenia, 49 patients with chronic schizophrenia and 40 healthy controls has been assessed in the areas of memory functions, speech and cognitive flexibility/abstraction. The three groups were comparable with regard to age, gender and education. Both patient groups showed a significant generalized neuropsychological impairment relative to controls. Patients with first episode were most impaired in visual motor processing and attention (VSM). Besides impairment in VSM, performance in abstraction/flexibility was significantly worse in chronic schizophrenics compared to first episode schizophrenics. Our findings suggest that neuropsychological functions are already impaired at the onset of the illness. Whether cognitive impairment in performance that is attributed to frontal dysfunctions is deteriorating during the course of the illness or is predicting an unfavourable course can only be answered by prospective follow-up studies.

Neuropsychological impairment and psychopathology in first-episode schizophrenic patients related to the early course of illness.

The objective of the present study was to explore whether the early course of illness including first onset of psychotic symptoms influences neuropsychological functioning and psychopathology in first-episode schizophrenics. Patients with a short prodromal period (n = 20) and patients with a long prodromal period (n = 20) and controls matched with regard to age, gender and education (n = 40) were administered a battery of standardized neuropsychological tests and psychopathological rating scales. The results indicate an overall difference in neuropsychological performance with the schizophrenic patients scoring lower than controls. Schizophrenic patients scored significantly lower in all subtests except in visual memory and abstraction/flexibility than controls. No significant difference between neuropsychological performance between patient samples was found. Psychopathology was more pronounced in the long prodromal period group rating higher on negative and affective symptoms compared with the short prodromal period group. The data suggests that neuropsychological deficits in first-episode schizophrenia are independent of the early course of schizophrenia, and although negative symptoms are associated with the length of the prodromal period, they do not imply greater neuropsychological impairment.

Are there gender differences in neuropsychological performance in patients with first-episode schizophrenia?

To investigate gender differences in neuropsychological (NP) functioning in first episode (FE) schizophrenia, consecutively recruited patients with FE schizophrenia (37 males, 29 females) and a subsample of these patients (20 males, 20 females), individually matched for gender, age, and education to healthy controls (20 males, 20 females) were compared on a battery of standardized neuropsychological tests. Women performed better than men in tests of verbal memory and learning, and men performed better than women in spatial organization. However, no differences were present between schizophrenic patients and controls, except that male and female schizophrenic patients showed the most pronounced impairment in visual motor processing, attention and verbal memory and learning. Our data suggest that gender does not appear markedly to modify the cognitive impairment characteristic of schizophrenia. However, they underline the necessity of controlling confounding factors on NP performance such as gender and education.

Contrasts in neuropsychological test profile between patients with first-episode schizophrenia and first-episode affective disorders.

Patients with first-episode (FE) schizophrenia (n = 27), unipolar depression (n = 10) and bipolar disorder (n = 17) and age- and gender-matched healthy control subjects (n = 27) were administered a battery of neuropsychological (NP) tests. FE schizophrenics performed significantly less well than patients with affective disorders in the area of visual motor processing and attention. Affective disorder patients without psychotic features did not perform significantly differently to controls. However, affective disorder patients with psychotic features performed as poorly as schizophrenics, with the most pronounced impairment in the area of visual motor processing and attention. Our data tentatively suggest the existence of a dichotomy in neuropsychological impairment, with psychotic patients showing similar neuropsychological deficits, while non-psychotic affective patients perform comparably to controls.

Neuropsychological impairment in first-episode and chronic schizophrenic patients.

Patients with first-episode (FE) schizophrenia (n = 40), with chronic schizophrenia (n = 40) and healthy controls (n = 40) matched for age, gender, education and parental socioeconomic status were administered a battery of standardized neuropsychological (NP) tests. Both patient groups showed generalized impairment relative to controls and the most pronounced deficits in visual-motor processing and attention (VSM). Compared with FE patients, chronic schizophrenics performed worse in VSM and abstraction/flexibility. Our findings suggest that NP deficits are fundamental manifestations of the illness, and that mainly frontally based dysfunctions are more prominent in chronic, kraepelinian patients.