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A comparison of cognitive functioning in acute schizophrenia and depression

Published online by Cambridge University Press:  29 May 2013

Tina Gooren ,
Peter Schlattmann  and
Peter Neu
Tina Gooren
Affiliation:
Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
Peter Schlattmann
Affiliation:
Institute of Clinical Epidemiology, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany Institute of Statistics, University of Jena, Jena, Germany
Peter Neu*
Affiliation:
Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany Clinic of Psychiatry and Psychotherapy, Jewish Hospital Berlin, Berlin, Germany
*
Peter Neu, Clinic of Psychiatry and Psychotherapy, Jewish Hospital Berlin, Heinz-Galinski-Str. 1, Berlin, Germany. Tel: +49 30 4994 2461; Fax: +49 30 4994 2503; E-mail: peter.neu@charite.de
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Abstract

Objective

Even though cognitive deficits are well recognised in schizophrenia and depression, direct comparisons between the disorders are scarce in literature. This study aims to assess specificity and degree of cognitive deficits in inpatients with acute schizophrenia and unipolar major depression.

Methods

A neuropsychological test battery was administered to 76 schizophrenic patients, 102 patients with unipolar major depression and 85 healthy controls (HCs), assessing verbal learning [Rey Auditory Verbal Learning Test (RAVLT)], processing speed (Trail Making Test), verbal fluency and visual memory (Wechsler Memory Scale-Revised test).

Results

Both patient groups were significantly impaired compared with HCs with regard to all test outcomes. The schizophrenia group (SG) performed significantly worse in the Wechsler Memory Scale and verbal fluency than the depression group (DG). The DG reached significantly lower scores than the SG in the RAVLT delayed recall subtest. No significant group difference between SG and DG was found for the Trail Making Test and the RAVLT direct recall trails.

Conclusion

Our results indicate that cognitive impairment is present in both disorders. Schizophrenic patients performed worse than patients with unipolar depression in only two of the administered tests. Differences in cognitive performance between the groups are not as general as often assumed. Therefore, during the acute phase of illness, a diagnostic classification on the grounds of the patients’ neurocognitive performance has to be done with caution.

Keywords

cognitive deficitcognitive impairmentdepressionschizophrenia
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 25 , Issue 6 , December 2013 , pp. 334 - 341
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2013 

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References

1.Zakzanis, KK, Leach, L, Kaplan, E. On the nature and pattern of neurocognitive function in major depressive disorder. Neuropsychiatry, Neuropsychol, and Behav Neurol 1998;11:111–119.Google ScholarPubMed
2.Porter, RJ, Bourke, C, Gallagher, P. Neuropsychological impairment in major depression: its nature, origin and clinical significance. Aust N Z J Psychiatry 2007;41:115–128.CrossRefGoogle ScholarPubMed
3.Austin, MP, Mitchell, P, Goodwin, GM. Cognitive deficits in depression: possible implications for functional neuropathology. Br J Psychiatry 2001;178:200–206.CrossRefGoogle ScholarPubMed
4.Green, MF. What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 1996;153:321–330.Google ScholarPubMed
5.Palmer, BW, Dawes, SE, Heaton, RK. What do we know about neuropsychological aspects of schizophrenia? Neuropsychol Rev 2009;19:365–384.CrossRefGoogle ScholarPubMed
6.Nuechterlein, KH, Barch, DM, Gold, JM, Goldberg, TE, Green, MF, Heaton, RK. Identification of separable cognitive factors in schizophrenia. Schizophr Res 2004;72:29–39.CrossRefGoogle ScholarPubMed
7.Krabbendam, L, Arts, B, van Os, J, Aleman, A. Cognitive functioning in patients with schizophrenia and bipolar disorder: a quantitative review. Schizophr Res 2005;80:137–149.CrossRefGoogle ScholarPubMed
8.Burt, DB, Zembar, MJ, Niederehe, G. Depression and memory impairment: a meta-analysis of the association, its pattern, and specificity. Psychol Bull 1995;117:285–305.CrossRefGoogle ScholarPubMed
9.Gualtieri, CT, Johnson, LG, Benedict, KB. Neurocognition in depression: patients on and off medication versus healthy comparison subjects. J Neuropsychiatry Clin Neurosci 2006;18:217–225.CrossRefGoogle ScholarPubMed
10.Buchanan, RW, Davis, M, Goff, Det al. A summary of the FDA-NIMH-MATRICS workshop on clinical trial design for neurocognitive drugs for schizophrenia. Schizophr Bull 2005;31:5–19.CrossRefGoogle ScholarPubMed
11.Gilvarry, CM, Barber, JA, van Os, J, Murray, RM. Neuropsychological performance of psychotic patients in community care: results from the UK700 study. Acta Psychiatr Scand Suppl 2001;408:81–91.CrossRefGoogle Scholar
12.Hill, SK, Reilly, JL, Harris, MSet al. A comparison of neuropsychological dysfunction in first-episode psychosis patients with unipolar depression, bipolar disorder, and schizophrenia. Schizophr Res 2009;113:167–175.CrossRefGoogle ScholarPubMed
13.Mojtabai, R, Bromet, EJ, Harvey, PD, Carlson, GA, Craig, TJ, Fennig, S. Neuropsychological differences between first-admission schizophrenia and psychotic affective disorders. Am J Psychiatry 2000;157:1453–1460.CrossRefGoogle ScholarPubMed
14.Reichenberg, A, Harvey, PD, Bowie, CRet al. Neuropsychological function and dysfunction in schizophrenia and psychotic affective disorders. Schizophr Bull 2009;35:1022–1029.CrossRefGoogle ScholarPubMed
15.Hill, SK, Keshavan, MS, Thase, ME, Sweeney, JA. Neuropsychological dysfunction in antipsychotic-naive first-episode unipolar psychotic depression. Am J Psychiatry 2004;161:996–1003.CrossRefGoogle ScholarPubMed
16.Fleming, SK, Blasey, C, Schatzberg, AF. Neuropsychological correlates of psychotic features in major depressive disorders: a review and meta-analysis. J Psychiatr Res 2004;38:27–35.CrossRefGoogle ScholarPubMed
17.Albus, M, Hubmann, W, Wahlheim, C, Sobizack, N, Franz, U, Mohr, F. Contrasts in neuropsychological test profile between patients with first-episode schizophrenia and first-episode affective disorders. Acta Psychiatr Scand 1996;94:87–93.CrossRefGoogle ScholarPubMed
18.Jeste, DV, Heaton, SC, Paulsen, JS, Ercoli, L, Harris, J, Heaton, RK. Clinical and neuropsychological comparison of psychotic depression with nonpsychotic depression and schizophrenia. Am J Psychiatry 1996;153:490–496.Google ScholarPubMed
19.Sostaric, M, Zalar, B. The overlap of cognitive impairment in depression and schizophrenia: a comparative study. Psychiatr Danub 2011;23:251–256.Google ScholarPubMed
20.Kay, SR, Fiszbein, A, Opler, LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261–276.CrossRefGoogle ScholarPubMed
21.Bech, P. The Bech-Rafaelsen Melancholia Scale (MES) in clinical trials of therapies in depressive disorders: a 20-year review of its use as outcome measure. Acta Psychiatr Scand 2002;106:252–264.CrossRefGoogle ScholarPubMed
22.Maier, W, Philipp, M, Heuser, I, Schlegel, S, Buller, R, Wetzel, H. Improving depression severity assessment – I. reliability, internal validity and sensitivity to change of three observer depression scales. J Psychiatr Res 1988;22:3–12.CrossRefGoogle ScholarPubMed
23.Licht, RW, Qvitzau, S, Allerup, P, Bech, P. Validation of the Bech-Rafaelsen Melancholia Scale and the Hamilton Depression Scale in patients with major depression; is the total score a valid measure of illness severity? Acta Psychiatr Scand 2005;111:144–149.CrossRefGoogle Scholar
24.Rey, A. L'Examen Clinique en Psychologie. Paris: Press Universitaire de France, 1964.Google Scholar
25.Reitan, R, Wolfson, D. The Halstead–Reitan neuropsychological test battery. Tucson: Neuropsycholoy Press, 1985.Google Scholar
26.Reitan, R. Trail making test: manual for administration and scoring. Tuscon AZ, 1992.Google Scholar
27.Bowie, CR, Harvey, PD. Administration and interpretation of the trail making test. Nat Protoc 2006;1:2277–2281.CrossRefGoogle ScholarPubMed
28.Story, TJ, Potter, GG, Attix, DK, Welsh-Bohmer, KA, Steffens, DC. Neurocognitive correlates of response to treatment in late-life depression. Am J Geriatr Psychiatry 2008;16:752–759.CrossRefGoogle ScholarPubMed
29.Spreen, O, Benton, AL. Neurosensory Center Comprehensive Examination for Aphasia (NCCEA), revised edition. Victoria: University of Victoria, Neuropsychology Laboratory, 1977.Google Scholar
30.Ratcliff, G, Ganguli, M, Chandra, Vet al. Effects of literacy and education on measures of word fluency. Brain Lang 1998;61:115–122.CrossRefGoogle ScholarPubMed
31.Wechsler, D. Wechsler Memory Scale-Revised. San Antonio, TX: The Psychological Corporation, 1987.Google Scholar
32.Gur, RC, Ragland, JD, Moberg, PJet al. Computerized neurocognitive scanning: II. The profile of schizophrenia. Neuropsychopharmacology 2001;25:777–788.CrossRefGoogle ScholarPubMed
33.Tuulio-Henriksson, A, Perala, J, Saarni, SIet al. Cognitive functioning in severe psychiatric disorders: a general population study. Eur Arch Psychiatry Clin Neurosci 2011;261:447–456.CrossRefGoogle ScholarPubMed
34.Midin, M, Razali, R, Zamzam, Ret al. Clinical and cognitive correlates of employment among patients with schizophrenia: a cross-sectional study in Malaysia. Int J Ment Health Syst 2011;5:14–21.CrossRefGoogle ScholarPubMed
35.Green, MF, Kern, RS, Braff, DL, Mintz, J. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the ‘right stuff’? Schizophr Bull 2000;26:119–136.CrossRefGoogle ScholarPubMed
36.Fossati, P, Amar, G, Raoux, N, Ergis, AM, Allilaire, JF. Executive functioning and verbal memory in young patients with unipolar depression and schizophrenia. Psychiatry Res 1999;89:171–187.CrossRefGoogle ScholarPubMed
37.Ozgurdal, S, Littmann, E, Hauser, Met al. Neurocognitive performances in participants of at-risk mental state for schizophrenia and in first-episode patients. J Clin Exp Neuropsychol 2009;31:392–401.CrossRefGoogle ScholarPubMed
38.Fioravanti, M, Carlone, O, Vitale, B, Cinti, ME, Clare, L. A meta-analysis of cognitive deficits in adults with a diagnosis of schizophrenia. Neuropsychol Rev 2005;15:73–95.CrossRefGoogle ScholarPubMed
39.Dillon, C, Taragano, F, Sarasola, Det al. Cognitive performance in schizophrenia (paranoid vs residual subtype). Vertex 2007;18:170–175.Google ScholarPubMed
40.Seltzer, J, Conrad, C, Cassens, G. Neuropsychological profiles in schizophrenia: paranoid versus undifferentiated distinctions. Schizophr Res 1997;23:131–138.CrossRefGoogle ScholarPubMed
41.Knubben, K, Reischies, FM, Adli, M, Schlattmann, P, Bauer, M, Dimeo, F. A randomised, controlled study on the effects of a short-term endurance training programme in patients with major depression. Br J Sports Med 2007;41:29–33.CrossRefGoogle Scholar
42.Dickerson, F, Boronow, JJ, Stallings, C, Origoni, AE, Cole, SK, Yolken, RH. Cognitive functioning in schizophrenia and bipolar disorder: comparison of performance on the Repeatable Battery for the Assessment of Neuropsychological Status. Psychiatry Res 2004;129:45–53.CrossRefGoogle ScholarPubMed
43.Addington, J, Addington, D. Cognitive functioning in first-episode schizophrenia. J Psychiatry Neurosci 2002;27:188–192.Google ScholarPubMed
44.Hughes, C, Kumari, V, Das, Met al. Cognitive functioning in siblings discordant for schizophrenia. Acta Psychiatr Scand 2005;111:185–192.CrossRefGoogle ScholarPubMed
45.Green, EK, Grozeva, D, Jones, Iet al. The bipolar disorder risk allele at CACNA1C also confers risk of recurrent major depression and of schizophrenia. Mol Psychiatry 2010;15:1016–1022.CrossRefGoogle ScholarPubMed
46.Meyer-Lindenberg, A, Weinberger, DR. Intermediate phenotypes and genetic mechanisms of psychiatric disorders. Nat Rev Neurosci 2006;7:818–827.CrossRefGoogle ScholarPubMed
47.Millan, MJ, Agid, Y, Brune, Met al. Cognitive dysfunction in psychiatric disorders: characteristics, causes and the quest for improved therapy. Nat Rev Drug Discov 2012;11:141–168.CrossRefGoogle ScholarPubMed
48.Tost, H, Bilek, E, Meyer-Lindenberg, A. Brain connectivity in psychiatric imaging genetics. Neuroimage 2011;62:2250–2260.CrossRefGoogle ScholarPubMed
49.Aleman, A, Kahn, RS, Selten, JP. Sex differences in the risk of schizophrenia: evidence from meta-analysis. Arch Gen Psychiatry 2003;60:565–571.CrossRefGoogle ScholarPubMed
50.McGrath, J, Saha, S, Welham, J, El Saadi, O, MacCauley, C, Chant, D. A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Med 2004;2:13–25.CrossRefGoogle ScholarPubMed
51.Kessler, RC, Bromet, EJ. The epidemiology of depression across cultures. Annu Rev Public Health 2013;34:119–138.CrossRefGoogle ScholarPubMed
52.Schretlen, DJ, Cascella, NG, Meyer, SMet al. Neuropsychological functioning in bipolar disorder and schizophrenia. Biol Psychiatry 2007;62:179–186.CrossRefGoogle ScholarPubMed