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Executive functioning and psychopathological profile in relatives of individuals with deficit v. non-deficit schizophrenia: a pilot study

  • S. Scala (a1) (a2), A. Lasalvia (a1), L. J. Seidman (a2), D. Cristofalo (a1), C. Bonetto (a1) and M. Ruggeri (a1)...

Abstract

Aims.

Heterogeneity of schizophrenia is known to be reflected in neuropsychological functioning of patients, but its expression in relatives is understudied. This study aims at exploring relationship between executive functioning and clinical profiles of first-degree relatives of patients who are classified as having or not having the deficit subtype of schizophrenia (DSRELs v. non-DSRELs), with the prediction of greater executive impairment in DSRELs.

Methods.

DSRELs (n = 15) and non-DSRELs (n = 40) were compared with community controls (CCs, n = 55) on executive functioning measured by the Wisconsin Card Sorting Test (WCST) and the phonemic verbal fluency (PVF), and clinical measures. Effects of psychopathology and intelligence quotient (IQ) measures were investigated to determine their association with executive performance.

Results.

DSRELs showed more executive dysfunction on WCST and poorer social functioning than CCs and more severe negative symptoms than non-DSRELs. Differences on WCST-categories achieved (WCST-CA) remained significant after adjustment for clinical confounders and IQ. WCST-CA was associated with apathy and paranoid ideation only within the DSREL subgroup.

Conclusions.

Executive functioning and negative symptoms are severely impaired in first-degree relatives of deficit syndrome patients, thus suggesting that some neurocognitive deficits in patients may be transmitted within families according to the pathophysiology of the probands.

Copyright

Corresponding author

*Address for correspondence: Dr A. Lasalvia, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, P.le L.A. Scuro, 10, 37134 Verona, Italy. (Email: antonio.lasalvia@univr.it)

References

Hide All
APA (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). American Psychiatric Association, Washington, DC.
Agnew-Blais, J, Seidman, LJ (2012). Neurocognition in youth and young adults under age 30 at familial risk for schizophrenia: a quantitative and qualitative review. Cognitive Neuropsychiatry, 139.
Amaddeo, F, Beecham, J, Bonizzato, P, Fenyo, A, Knapp, M, Tansella, M (1997). The use of a case register to evaluate the costs of psychiatric care. Acta Psychiatrica Scandinavica 95, 189198.
Amador, XF, Kirkpatrick, B, Buchanan, RW, Carpenter, WT, Marcinko, L, Yale, SA (1999). Stability of the diagnosis of deficit syndrome in schizophrenia. American Journal of Psychiatry 156, 637639.
Andreasen, NC (1983). The Scale of the Assessment of Negative Symptoms (SANS). University of Iowa: Iowa City.
Andreasen, NC, Olsen, SA (1982). Negative vs. Positive schizophrenia: definition and validation. Archives of General Psychiatry 39, 789794.
Barch, DM, Dowd, EC (2010). Goal representations and motivational drive in schizophrenia: the role of prefrontal–striatal interactions. Schizophrenia Bulletin 36, 919934.
Barrantes-Vidal, N, Aguilera, M, Campanera, S, Fatjó-Vilas, M, Guitart, M, Miret, S, Valero, S, Fañanás, L (2007). Working memory in siblings of schizophrenia patients. Schizophrenia Research 95, 7075.
Bates, JA, Malhotra, AK (2002). Genetic factors and neurocognitive traits. CNS Spectrums 7, 274–280, 283284.
Bellani, M, Perlini, C, Brambilla, P (2009). Language disturbances in schizophrenia. Epidemiology and Psychiatric Sciences 18, 314317.
Benoit, A, Bodnar, M, Malla, AK, Joober, R, Lepage, M (2012). The structural neural substrates of persistent negative symptoms in first-episode of non-affective psychosis: a voxel-based morphometry study. Frontiers in Psychiatry 3, 42.
Brooker, BH, Cyr, JJ (1986). Tables for clinicians to use to convert WAIS-R short forms. Journal of Clinical Psychology 42, 982986.
Bryson, G, Whelahan, HA, Bell, M (2001). Memory and executive function impairments in deficit syndrome schizophrenia. Psychiatry Research 102, 2937.
Buchanan, RW, Kirkpatrick, B, Heinrichs, DW, Carpenter, WT Jr (1990). Clinical correlates of the deficit syndrome of schizophrenia. American Journal of Psychiatry 147, 290294.
Buchanan, RW, Strauss, ME, Kirkpatrick, B, Holstein, C, Breier, A, Carpenter, WT Jr (1994). Neuropsychological impairments in deficit vs. nondeficit forms of schizophrenia. Archives of General Psychiatry 51, 804811.
Buchanan, RW, Strauss, ME, Breier, A, Kirkpatrick, B, Carpenter, WT Jr. (1997). Attentional impairments in deficit and nondeficit forms of schizophrenia. American Journal of Psychiatry 154, 363370.
Byrne, M, Hodges, A, Grant, E, Owens, DC, Johnstone, EC (1999). Neuropsychological assessment of young people at high genetic risk for developing schizophrenia compared with controls: preliminary findings of the Edinburgh High Risk Study (EHRS). Psychological Medicine 29, 11611173.
Cannon, TD, Glahn, DC, Kim, J, Van Erp, TG, Karlsgodt, K, Cohen, MS, Nuechterlein, KH, Bava, S, Shirinyan, D (2005). Dorsolateral prefrontal cortex activity during maintenance and manipulation of information in working memory in patients with schizophrenia. Archives of General Psychiatry 62, 10711080.
Carpenter, WT Jr., Kirkpatrick, B (1988). The heterogeneity of the long-term course of schizophrenia. Schizophrenia Bulletin 14, 645652.
Carpenter, WT, Heirrichs, DW, Wagner, AMI (1988). Deficit and nondeficit forms of schizophrenia: the concept. American Journal of Psychiatry 145, 578583.
Cascella, NG, Fieldstone, SC, Rao, VA, Pearlson, GD, Sawa, A, Schretlen, DJ (2010). Gray-matter abnormalities in deficit schizophrenia. Schizophrenia Research 120, 6370.
Castle, DJ, Sham, PC, Wessely, S, Murray, RM (1994). The subtyping of schizophrenia in men and women: a latent class analysis. Psychological Medicine 24, 4151.
Cohen, AS, Brown, LA, Minor, KS (2010). The psychiatric symptomatology of deficit schizophrenia: a meta-analysis. Schizophrenia Research 118, 122–7.
Cohen, AS, Saperstein, AM, Gold, JM, Kirkpatrick, B, Carpenter, WT Jr., Buchanan, RW (2007). Neuropsychology of the deficit syndrome: new data and meta-analysis of findings to date. Schizophrenia Bulletin 33, 12011212.
Cohen, J (1988). Statistical Power Analysis for the Behavioral Sciences, 2nd ed.Lawrence Earlbaum Associates, Hillsdale, NJ.
Compton, RJ, Banich, MT, Mohanty, A, Milham, MP, Herrington, J, Miller, GA, Scalf, PE, Webb, A, Heller, W (2003). Paying attention to emotion: an fMRI investigation of cognitive and emotional Stroop tasks. Cognitive, Affective and Behavioral Neurosciece 3, 8196.
Conklin, HM, Curtis, CE, Calkins, ME, Iacono, WG (2005). Working memory functioning in schizophrenia patients and their first-degree relatives: cognitive functioning shedding light on etiology. Neuropsychologia 43, 930942.
Crow, TJ (1985). The two-syndrome concept: origins and current status. Schizophrenia Bulletin 11, 471786.
Cuesta, MJ, Peralta, V, Caro, F, de Leon, J (1995). Schizophrenic syndrome and Wisconsin Card Sorting Test dimensions. Psychiatry Research 58, 4551.
Delamillieure, P, Fernandez, J, Constans, JM, Brazo, P, Benali, K, Abadie, P, Vasse, T, Thibaut, F, Courtheoux, P, Petit, M, Dollfus, S (2000). Proton magnetic resonance spectroscopy of the medial prefrontal cortex in patients with deficit schizophrenia: preliminary report. American Journal of Psychiatry 157, 641643.
Delamillieure, P, Constans, JM, Fernandez, J, Brazo, P, Dollfus, S (2004). Relationship between performance on the Stroop test and N-acetylaspartate in the medial prefrontal cortex in deficit and nondeficit schizophrenia: preliminary results. Psychiatry Research: Neuroimaging 132, 8789.
Derogatis, LR (1993). Symptom Checklist-90-R (SCL-90). Computer Systems: Minneapolis.
Dollfus, S, Ribeyre, JM, Petit, M (1996). Family history and deficit form in schizophrenia. European Psychiatry 11, 260262.
Dollfus, S, Germain-Robin, S, Chabot, B, Brazo, P, Delamillieure, P, Langlois, S, van der Eist, A, Campion, D, Petit, M (1998). Family history and obstetric complications in deficit and non-deficit schizophrenia: preliminary results. European Psychiatry 13, 270272.
Dominguez, MG, Viechtbauer, W, Simons, CJ, van Os, J, Krabbendam, L (2009). Are psychotic psychopathology and neurocognition orthogonal? A systematic review of their associations. Psychological Bulletin 135, 157171.
Erol, A, Bayram, S, Kosger, F, Mete, L (2012). Executive functions in patients with familial versus sporadic schizophrenia and their parents. Neuropsychobiology 17, 9399.
Faraone, SV, Seidman, LJ, Kremen, WS, Pepple, JR, Lyons, MJ, Tsuang, MT (1995). Neuropsychological functioning among the nonpsychotic relatives of schizophrenic patients: a diagnostic efficiency analysis. Journal of Abnormal Psychology 104, 286304.
Faraone, SV, Seidman, LJ, Kremen, WS, Toomey, R, Lyons, MJ, Tsuang, MT (1996). Neuropsychological functioning among the elderly nonpsychotic relatives of schizophrenic patients. Schizophrenia Research 20, 2731.
Fenton, WS, McGlashan, TH (1994). Antecedents, symptom progression, and long-term outcome of the deficit syndrome in schizophrenia. American Journal of Psychiatry 151, 351356.
Goetz, RR, Corcoran, C, Yale, S, Stanford, AD, Kimhy, D, Amador, X, Malaspina, D (2007). Validity of a 'proxy' for the deficit syndrome derived from the positive and negative syndrome scale (PANSS). Schizophrenia Research 93, 169177.
Goghari, VM (2011). Executive functioning related brain abnormalities associated with the genetic liability for schizophrenia: an activation likelihood estimation meta-analysis. Psychological Medicine 41, 12391252.
Gonul, AS, Kula, M, Esel, E, Tutus, A, Sofuoglu, S (2003). A Tc-99 m HMPAO SPECT study of regional cerebral blood flow in drug-free schizophrenic patients with deficit and non-deficit syndrome. Psychiatry Research: Neuroimaging 123, 199205.
Gur, RE, Nimgaonkar, VL, Almasy, L, Calkins, ME, Ragland, JD, Pogue-Geile, MF, Kanes, S, Blangero, J, Gur, RC (2007). Neurocognitive endophenotypes in a multiplex multigenerational family study of schizophrenia. American Journal of Psychiatry 164, 813819.
Heaton, RK (1981). Wisconsin Card Sorting Test. Psychological Assessment Resources: Odessa.
Heckers, S, Goff, D, Schacter, DL, Savage, CR, Fischman, AJ, Alpert, NM, Rauch, SL (1999). Functional imaging of memory retrieval in deficit vs. nondeficit schizophrenia. Archives of General Psychiatry 56, 11171123.
Kay, SR, Fiszbein, A, Opler, LA (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261–76.
Kimhy, D, Yale, S, Goetz, RR, Marcinko McFarr, L, Malaspina, D (2006). The factorial structure of the schedule for the deficit syndrome in schizophrenia. Schizophrenia Bulletin 32, 274278.
Kirkpatrick, B, Galderisi, S (2008). Deficit schizophrenia: an update. World Psychiatry 7, 143147.
Kirkpatrick, B, Buchanan, RW, McKenney, PD, Alphs, LD, Carpenter, WT Jr. (1989). The schedule for the deficit syndrome: an instrument for research in schizophrenia. Psychiatry Research 30, 119123.
Kirkpatrick, B, Buchanan, RW, Breier, A, Carpenter, WT Jr. (1993). Case identification and stability of the deficit syndrome of schizophrenia. Psychiatry Research 47, 4756.
Kirkpatrick, B, Ross, DE, Walsh, D, Karkowski, L, Kendler, KS (2000). Family characteristics of deficit and nondeficit schizophrenia in the Roscommon family study. Schizophrenia Research 45, 5764.
Kravariti, E, Russo, M, Vassos, E, Morgan, K, Fearon, P, Zanelli, JW, Demjaha, A, Lappin, JM, Tsakanikos, E, Dazzan, P, Morgan, C, Doody, GA, Harrison, G, Jones, PB, Murray, RM, Reichenberg, A (2012). Linear and non-linear associations of symptom dimensions and cognitive function in first-onset psychosis. Schizophrenia Research 140, 221231.
Lahti, AC, Holcomb, HH, Medoff, DR, Weiler, MA, Tamminga, CA, Carpenter, WT Jr. (2001). Abnormal patterns of regional cerebral blood flow in schizophrenia with primary negative symptoms during an effortful auditory recognition task. American Journal of Psychiatry 158, 17971808.
Lin, A, Nelson, B, Yung, AR (2012). 'At-risk' for psychosis research: where are we heading? Epidemiology and Psychiatric Sciences 30, 16.
Milham, MP, Banich, MT, Barad, V (2003). Competition for priority in processing increases prefrontal cortex's involvement in top-down control: an event-related fMRI study of the Stroop task. Cognitive Brain Research 17, 212222.
Milner, B (1975). Psychological aspects of focal epilepsy and its neurosurgical management. Advances in Neurology 8, 299321.
Nakaya, M, Ohmori, K (2008). A two-factor structure for the Deficit Syndrome in schizophrenia. Psychiatry Research 158, 256259.
Nuechterlein, KH, Barch, DM, Gold, JM, Goldberg, TE, Green, MF, Heaton, RK (2004). Identification of separable cognitive factors in schizophrenia. Schizophrenia Research 72, 2939.
Ochsner, KN, Gross, JJ (2005). The cognitive control of emotion. Trends in Cognitive Sciences 9, 242249.
Pogue-Geile, MF, Harrow, M (1985). Negative symptoms in schizophrenia: their longitudinal course and prognostic importance. Schizophrenia Bulletin 11, 427439.
Polgár, P, Réthelyi, JM, Bálint, S, Komlósi, S, Czobor, P, Bitter, I (2010). Executive function in deficit schizophrenia: what do the dimensions of the Wisconsin Card Sorting Test tell us? Schizophrenia Research 122, 8593.
Réthelyi, JM, Czobor, P, Polgár, P, Mersich, B, Bálint, S, Jekkel, E, Magyar, K, Mészáros, A, Fábián, A, Bitter, I (2012). General and domain-specific neurocognitive impairments in deficit and non-deficit schizophrenia. European Archives of Psychiatry and Clinical Neuroscience 262, 107115.
Ross, DE, Kirkpatrick, B, Karkowski, LM, Straub, RE, MacLean, CJ, O'Neill, FA, Compton, AD, Murphy, B, Walsh, D, Kendler, KS (2000). Sibling correlation of deficit syndrome in the Irish study of high-density schizophrenia families. American Journal of Psychiatry 157, 10711076.
Ross, E, Orbelo, D, Cartwright, J, Hansel, S, Burgard, M, Testa, J, Buck, R (2001). Affective-prosodic deficits in schizophrenia: profiles of patients with brain damage and comparison with relation to schizophrenic symptoms. Journal of Neurology, Neurosurgery and Psychiatry 70, 597604.
Rosso, IM, Makris, N, Thermenos, HW, Hodge, SM, Brown, A, Kennedy, D, Caviness, VS, Faraone, SV, Tsuang, MT, Seidman, LJ (2010). Regional prefrontal cortex gray matter volumes in youth at familial risk for schizophrenia from the Harvard Adolescent High Risk Study. Schizophrenia Research 123, 1521.
Scala, S, Lasalvia, A, Cristofalo, D, Bonetto, C, Ruggeri, M (2012). Neurocognitive profile and its association with psychopathology in first-degree relatives of patients with schizophrenia. A case-control study. Psychiatry Research 200, 137143.
Seidman, LJ, Thermenos, HW, Poldrack, RA, Peace, NK, Koch, JK, Faraone, SV, Tsuang, MT (2006). Altered brain activation in dorsolateral prefrontal cortex in adolescents and young adults at genetic risk for schizophrenia: An fMRI study of working memory. Schizophrenia Research 85, 5872.
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59, 2233.
Skelley, SL, Goldberg, TE, Egan, MF, Weinberger, DR, Gold, JM (2008). Verbal and visual memory: characterizing the clinical and intermediate phenotype in schizophrenia. Schizophrenia Research 105, 7885.
Snitz, BE, Macdonald, AW, Carter, CS (2006). Cognitive deficits in unaffected first-degree relatives of schizophrenia patients: a meta-analytic review of putative endophenotypes. Schizophrenia Bulletin 32, 179194.
Spitzer, R, Williams, JBV, Gibbon, M, First, MB (1990). Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). American Psychiatric Press, Washington, DC. (Italian Version: Fava M, Guaraldi GB, Mazzi F, Rigatelli M, 1993).
Stolar, N, Berenbaum, H, Banich, MT, Barch, D (1994). Neuropsychological correlates of alogia and affective flattening in schizophrenia. Biological Psychiatry 35, 164172.
Strauss, GP, Harrow, M, Grossman, LS, Rosen, C (2010). Periods of recovery in deficit syndrome schizophrenia: a 20-year multi-follow-up longitudinal study. Schizophrenia Bulletin 36, 788799.
Szoke, A, Schurhoff, F, Mathieu, F, Meary, A, Ionescu, S, Leboyer, M (2005). Tests of executive functions in first-degree relatives of schizophrenic patients: a meta-analysis. Psychological Medicine 35, 771782.
Tallent, KA, Gooding, DC (1999). Working memory and Wisconsin Card Sorting Test performance in schizotypic individuals: a replication and extension. Psychiatry Research 89, 161170.
Tamminga, CA, Thaker, OK, Buchanan, R, Kirkpatrick, B, Alphs, LD, Chase, TN, Carpenter, WT (1992). Limbic system abnormalities identified in schizophrenia using positron emission tomography with fluorodeoxyglucose and neocortical alterations with deficit syndrome. Archives of General Psychiatry 49, 522530.
Tansella, M, Amaddeo, F, Burti, L, Lasalvia, A, Ruggeri, M (2006). Evaluating a community-based mental health service focusing on severe mental illness. The Verona experience. Acta Psychiatrica Scandinavica 429, 9094.
Taylor, SF, Welsh, RC, Wager, TD, Phan, KL, Fitzgerald, KD, Gehring, WJ (2004). Functional neuroimaging study of motivation and executive function. Neuroimage 21, 10451054.
Tek, C, Kirkpatrick, B, Buchanan, RW (2001). A five-year follow-up study of deficit and nondeficit schizophrenia. Schizophrenia Research 49, 253260.
Thabane, L, Ma, J, Chu, R, Cheng, J, Ismaila, A, Rios, LP, Robson, R, Thabane, M, Giangregorio, L, Goldsmith, CH (2010). A tutorial on pilot studies: the what, why and how. BMC Medical Research Methodology 10, 1.
Turetsky, B, Cowell, PE, Gur, RC, Grossman, RI, Shtasel, DL, Gur, RE (1995). Frontal and temporal lobe brain volumes in schizophrenia. Relationship to symptoms and clinical subtype. Volumetric measure of the frontal and temporal lobe regions in schizophrenia: relationship to negative symptoms. Archives of General Psychiatry 52, 10611070.
Vollema, MG, Postma, B (2002). Neurocognitive correlates of schizotypy in first degree relatives of schizophrenia patients. Schizophrenia Bulletin 28, 367377.
Wang, XS, Yao, S, Kirkpatrick, B, Shi, C, Yi, J (2008). Psychopathology and neuropsychological impairments in deficit and nondeficit schizophrenia of Chinese origin. Psychiatry Research 158, 195205.
World Health Organization (1988). Disability Assessment Schedule-II (DAS). World Health Organization: Geneva.

Keywords

Executive functioning and psychopathological profile in relatives of individuals with deficit v. non-deficit schizophrenia: a pilot study

  • S. Scala (a1) (a2), A. Lasalvia (a1), L. J. Seidman (a2), D. Cristofalo (a1), C. Bonetto (a1) and M. Ruggeri (a1)...

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