Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-20T04:00:21.961Z Has data issue: false hasContentIssue false
  • English
  • Français

Intelligence decline across major depressive disorder, bipolar disorder, and schizophrenia

Published online by Cambridge University Press:  18 March 2021

Kazutaka Ohi Open the ORCID record for Kazutaka Ohi [Opens in a new window] ,
Kentaro Takai ,
Shunsuke Sugiyama ,
Hiromi Kitagawa ,
Yuzuru Kataoka ,
Midori Soda ,
Kiyoyuki Kitaichi ,
Yasuhiro Kawasaki ,
Munechika Ito  and
Toshiki Shioiri
Kazutaka Ohi*
Affiliation:
Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan Department of General Internal Medicine, Kanazawa Medical University, Kahoku, Japan
Kentaro Takai
Affiliation:
Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
Shunsuke Sugiyama
Affiliation:
Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
Hiromi Kitagawa
Affiliation:
Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
Yuzuru Kataoka
Affiliation:
Department of Neuropsychiatry, Kanazawa Medical University, Kahoku, Japan
Midori Soda
Affiliation:
Laboratory of Pharmaceutics, Department of Biomedical Pharmaceutics, Gifu Pharmaceutical University, Gifu, Japan
Kiyoyuki Kitaichi
Affiliation:
Laboratory of Pharmaceutics, Department of Biomedical Pharmaceutics, Gifu Pharmaceutical University, Gifu, Japan
Yasuhiro Kawasaki
Affiliation:
Department of Neuropsychiatry, Kanazawa Medical University, Kahoku, Japan
Munechika Ito
Affiliation:
Faculty of Education, Gifu University, Gifu, Japan
Toshiki Shioiri
Affiliation:
Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
*
*Author for correspondence: Kazutaka Ohi, MD, PhD, Email: k_ohi@gifu-u.ac.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SCZ) are associated with impaired intelligence that predicts poor functional outcomes. However, little is known regarding the extent and severity of intelligence decline, that is, decreased present intelligence quotient (IQ) relative to premorbid levels, across psychiatric disorders and which clinical characteristics affect the decline.

Methods

Premorbid IQ, present IQ, and intelligence decline were compared across patients with MDD (n = 45), BD (n = 30), and SCZ (n = 139), and healthy controls (HCs; n = 135). Furthermore, we investigated which factors contribute to the intelligence decline in each diagnostic group.

Results

Significant differences were observed in premorbid IQ, present IQ, and intelligence decline across the diagnostic groups. Patients with each psychiatric disorder displayed lower premorbid and present IQ and more intelligence decline than HCs. Patients with SCZ displayed lower premorbid and present IQ and more intelligence decline than patients with MDD and BD, while there were no significant differences between patients with MDD and BD. When patients with BD were divided based on bipolar I disorder (BD-I) and bipolar II disorder (BD-II), degrees of intelligence decline were similar between MDD and BD-II and between BD-I and SCZ. Lower educational attainment was correlated with a greater degree of intelligence decline in patients with SCZ and BD but not MDD.

Conclusions

These findings confirm that although all psychiatric disorders display intelligence decline, the severity of intelligence decline differs across psychiatric disorders (SCZ, BD-I > BD-II, MDD > HCs). Higher educational attainment as cognitive reserve contributes to protection against intelligence decline in BD and SCZ.

Keywords

Major depressive disorderbipolar disorderschizophreniapremorbid IQpresent IQintelligence decline
Type
Original Research
Information
CNS Spectrums , Volume 27 , Issue 4 , August 2022 , pp. 468 - 474
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Keefe, RS, Fenton, WS. How should DSM-V criteria for schizophrenia include cognitive impairment? Schizophr Bull. 2007;33(4):912–920.CrossRefGoogle ScholarPubMed
Schaefer, J, Giangrande, E, Weinberger, DR, et al. The global cognitive impairment in schizophrenia: consistent over decades and around the world. Schizophr Res. 2013;150(1):42–50.CrossRefGoogle ScholarPubMed
Marazziti, D, Consoli, G, Picchetti, M, et al. Cognitive impairment in major depression. Eur J Pharmacol. 2010;626(1):83–86.CrossRefGoogle ScholarPubMed
Solé, B, Jiménez, E, Torrent, C, et al. Cognitive variability in bipolar II disorder: who is cognitively impaired and who is preserved. Bipolar Disord. 2016;18(3):288–299.CrossRefGoogle ScholarPubMed
Trotta, A, Murray, RM, MacCabe, JH. Do premorbid and post-onset cognitive functioning differ between schizophrenia and bipolar disorder? A systematic review and meta-analysis. Psychol Med. 2015;45(2):381–394.CrossRefGoogle ScholarPubMed
Stordal, KI, Lundervold, AJ, Egeland, J, et al. Impairment across executive functions in recurrent major depression. Nord J Psychiatry. 2004;58(1):41–47.CrossRefGoogle ScholarPubMed
Reichenberg, A, Harvey, PD, Bowie, CR, et al. Neuropsychological function and dysfunction in schizophrenia and psychotic affective disorders. Schizophr Bull. 2009;35(5):1022–1029.CrossRefGoogle ScholarPubMed
Jaeger, J, Berns, S, Loftus, S, et al. Neurocognitive test performance predicts functional recovery from acute exacerbation leading to hospitalization in bipolar disorder. Bipolar Disord. 2007;9(1–2):93–102.CrossRefGoogle ScholarPubMed
Kahn, RS, Keefe, RS. Schizophrenia is a cognitive illness: time for a change in focus. JAMA Psychiatry. 2013;70(10):1107–1112.CrossRefGoogle ScholarPubMed
Green, MF, Kern, RS, Braff, DL, et al. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the “right stuff”? Schizophr Bull. 2000;26(1):119–136.CrossRefGoogle ScholarPubMed
Green, MF. What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry. 1996;153(3):321–330.Google Scholar
Badcock, JC, Dragovic, M, Waters, FA, et al. Dimensions of intelligence in schizophrenia: evidence from patients with preserved, deteriorated and compromised intellect. J Psychiatr Res. 2005;39(1):11–19.CrossRefGoogle ScholarPubMed
Tohen, M, Zarate, CA Jr, Hennen, J , et al. The McLean–Harvard first-episode mania study: prediction of recovery and first recurrence. Am J Psychiatry. 2003;160(12):2099–2107.CrossRefGoogle ScholarPubMed
Caldiroli, A, Buoli, M, Serati, M, et al. General and social cognition in remitted first-episode schizophrenia patients: a comparative study. Eur Arch Psychiatry Clin Neurosci. 2016;266(7):639–647.CrossRefGoogle ScholarPubMed
Wells, R, Swaminathan, V, Sundram, S, et al. The impact of premorbid and current intellect in schizophrenia: cognitive, symptom, and functional outcomes. NPJ Schizophr. 2015;1:15043.CrossRefGoogle ScholarPubMed
Ohi, K, Sumiyoshi, C, Fujino, H, et al. A brief assessment of intelligence decline in schizophrenia as represented by the difference between current and premorbid intellectual quotient. Front Psychiatry. 2017;8:293. CrossRefGoogle ScholarPubMed
Dykiert, D, Deary, IJ. Retrospective validation of WTAR and NART scores as estimators of prior cognitive ability using the Lothian Birth Cohort 1936. Psychol Assess. 2013;25(4):1361–1366.CrossRefGoogle ScholarPubMed
Mathias, JL, Bowden, SC, Barrett-Woodbridge, M. Accuracy of the Wechsler Test of Adult Reading (WTAR) and National Adult Reading Test (NART) when estimating IQ in a healthy Australian sample. Aust Psychol. 2007;42(1):49–56.CrossRefGoogle Scholar
Mullen, CM, Fouty, HE. Comparison of the WRAT4 reading subtest and the WTAR for estimating premorbid ability level. Appl Neuropsychol Adult. 2014;21(1):69–72.CrossRefGoogle ScholarPubMed
Crawford, JR, Besson, JA, Parker, DM, et al. Estimation of premorbid intellectual status in depression. Br J Clin Psychol. 1987;26(4):313–314.CrossRefGoogle ScholarPubMed
Ohi, K, Shimada, T, Kataoka, Y, et al. Intelligence decline between present and premorbid IQ in schizophrenia: Schizophrenia Non-Affected Relative Project (SNARP). Eur Neuropsychopharmacol. 2019;29(5):653–661.CrossRefGoogle Scholar
Vaskinn, A, Haatveit, B, Melle, I, et al. Cognitive heterogeneity across schizophrenia and bipolar disorder: a cluster analysis of intellectual trajectories. J Int Neuropsychol Soc. 2020;26(9):860–872.CrossRefGoogle ScholarPubMed
Agnew-Blais, JC, Buka, SL, Fitzmaurice, GM, et al. Early childhood IQ trajectories in individuals later developing schizophrenia and affective psychoses in the New England family studies. Schizophr Bull. 2015;41(4):817–823.CrossRefGoogle ScholarPubMed
Koenen, KC, Moffitt, TE, Roberts, AL, et al. Childhood IQ and adult mental disorders: a test of the cognitive reserve hypothesis. Am J Psychiatry. 2009;166(1):50–57.CrossRefGoogle ScholarPubMed
Weinberger, DR. Implications of normal brain development for the pathogenesis of schizophrenia. Arch Gen Psychiatry. 1987;44(7):660–669.CrossRefGoogle ScholarPubMed
Sommer, IE, Bearden, CE, van Dellen, E, et al. Early interventions in risk groups for schizophrenia: what are we waiting for? NPJ Schizophr. 2016;2:16003. CrossRefGoogle ScholarPubMed
Hashimoto, R, Ikeda, M, Ohi, K, et al. Genome-wide association study of cognitive decline in schizophrenia. Am J Psychiatry. 2013;170(6):683–684.CrossRefGoogle Scholar
Fujino, H, Sumiyoshi, C, Yasuda, Y, et al. Estimated cognitive decline in patients with schizophrenia: a multicenter study. Psychiatry Clin Neurosci. 2017;71(5):294–300.CrossRefGoogle ScholarPubMed
Kataoka, Y, Shimada, T, Koide, Y, et al. Differences in executive function among patients with schizophrenia, their unaffected first-degree relatives and healthy participants. Int J Neuropsychopharmacol. 2020;23(11):731–737.CrossRefGoogle Scholar
Ohi, K, Matsuda, Y, Shimada, T, et al. Structural alterations of the superior temporal gyrus in schizophrenia: detailed subregional differences. Eur Psychiatry. 2016;35:25–31.CrossRefGoogle ScholarPubMed
Yasuyama, T, Ohi, K, Shimada, T, et al. Differences in social functioning among patients with major psychiatric disorders: interpersonal communication is impaired in patients with schizophrenia and correlates with an increase in schizotypal traits. Psychiatry Res. 2016;249:30–34.CrossRefGoogle ScholarPubMed
Ohi, K, Shimada, T, Kihara, H, et al. Impact of familial loading on prefrontal activation in major psychiatric disorders: a near-infrared spectroscopy (NIRS) study. Sci Rep. 2017;7:44268 CrossRefGoogle ScholarPubMed
Ohi, K, Kataoka, Y, Shimada, T, et al. Meta-analysis of physical activity and effects of social function and quality of life on the physical activity in patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci. 2019;269(5):517–527.CrossRefGoogle ScholarPubMed
Ohi, K, Shimada, T, Kuwata, A, et al. Smoking rates and number of cigarettes smoked per day in schizophrenia: a large cohort meta-analysis in a Japanese population. Int J Neuropsychopharmacol. 2019;22(1):19–27.CrossRefGoogle Scholar
Inada, T, Inagaki, A. Psychotropic dose equivalence in Japan. Psychiatry Clin Neurosci. 2015;69(8):440–447.CrossRefGoogle ScholarPubMed
Kay, SR, Fiszbein, A, Opler, LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13(2):261–276.CrossRefGoogle Scholar
Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23(1):56–62.CrossRefGoogle ScholarPubMed
Young, RC, Biggs, JT, Ziegler, VE, et al. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429–435.CrossRefGoogle ScholarPubMed
Dalby, JT, Williams, R. Preserved reading and spelling ability in psychotic disorders. Psychol Med. 1986;16(1):171–175.CrossRefGoogle ScholarPubMed
Amminger, GP, Edwards, J, Brewer, WJ, et al. Duration of untreated psychosis and cognitive deterioration in first-episode schizophrenia. Schizophr Res. 2002;54(3):223–230.CrossRefGoogle ScholarPubMed
Schretlen, DJ, Cascella, NG, Meyer, SM, et al. Neuropsychological functioning in bipolar disorder and schizophrenia. Biol Psychiatry. 2007;62(2):179–186.CrossRefGoogle ScholarPubMed
Schoeyen, HK, Melle, I, Sundet, K, et al. Occupational outcome in bipolar disorder is not predicted by premorbid functioning and intelligence. Bipolar Disord. 2013;15(3):294–305.CrossRefGoogle Scholar
Matsuoka, K, Uno, M, Kasai, K, et al. Estimation of premorbid IQ in individuals with Alzheimer’s disease using Japanese ideographic script (Kanji) compound words: Japanese version of National Adult Reading Test. Psychiatry Clin Neurosci. 2006;60(3):332–339.CrossRefGoogle ScholarPubMed
Ohi, K, Shimada, T, Nitta, Y, et al. Specific gene expression patterns of 108 schizophrenia-associated loci in cortex. Schizophr Res. 2016;174(1–3):35–38.CrossRefGoogle ScholarPubMed
Ohi, K, Kikuchi, M, Ikeda, M, et al. Polygenetic components for schizophrenia, bipolar disorder and rheumatoid arthritis predict risk of schizophrenia. Schizophr Res. 2016;175(1–3):226–229.CrossRefGoogle ScholarPubMed
Ohi, K, Hashimoto, R, Yasuda, Y, et al. Influence of the NRGN gene on intellectual ability in schizophrenia. J Hum Genet. 2013;58(10):700–705.CrossRefGoogle Scholar
Ohi, K, Hashimoto, R, Yamamori, H, et al. The impact of the genome-wide supported variant in the cyclin M2 gene on gray matter morphology in schizophrenia. Behav Brain Func. 2013;9:40.CrossRefGoogle Scholar
Ohi, K, Hashimoto, R, Ikeda, M, et al. Genetic risk variants of schizophrenia associated with left superior temporal gyrus volume. Cortex. 2014;58:23–26.CrossRefGoogle ScholarPubMed
Ohi, K, Hashimoto, R, Ikeda, M, et al. Glutamate networks implicate cognitive impairments in schizophrenia: genome-wide association studies of 52 cognitive phenotypes. Schizophr Bull. 2015;41(4):909–918.CrossRefGoogle ScholarPubMed
Wechsler, D. Wechsler Adult Intelligence Scale. 3rd ed. San Antonio, TX: The Psychological Corporation; 1997.Google Scholar
Sumiyoshi, C, Fujino, H, Sumiyoshi, T, et al. Usefulness of the Wechsler Intelligence Scale short form for assessing functional outcomes in patients with schizophrenia. Psychiatry Res. 2016;245:371–378.CrossRefGoogle ScholarPubMed
Pu, S, Noda, T, Setoyama, S, et al. Empirical evidence for discrete neurocognitive subgroups in patients with non-psychotic major depressive disorder: clinical implications. Psychol Med. 2018;48(16):2717–2729.CrossRefGoogle ScholarPubMed
Ohi, K, Sumiyoshi, C, Fujino, H, et al. Genetic overlap between general cognitive function and schizophrenia: a review of cognitive GWASs. Int J Mol Sci. 2018;19(12):3822 CrossRefGoogle ScholarPubMed
Lam, M, Trampush, JW, Yu, J, et al. Large-scale cognitive GWAS meta-analysis reveals tissue-specific neural expression and potential nootropic drug targets. Cell Rep. 2017;21(9):2597–2613.CrossRefGoogle ScholarPubMed
Sniekers, S, Stringer, S, Watanabe, K, et al. Genome-wide association meta-analysis of 78 308 individuals identifies new loci and genes influencing human intelligence. Nat Genet. 2017;49(7):1107–1112.CrossRefGoogle ScholarPubMed
Trampush, JW, Yang, ML, Yu, J, et al. GWAS meta-analysis reveals novel loci and genetic correlates for general cognitive function: a report from the COGENT consortium. Mol Psychiatry. 2017;22(3):336–345.CrossRefGoogle ScholarPubMed
Wray, NR, Ripke, S, Mattheisen, M, et al. Genome-wide association analyses identify 44 risk variants and refine the genetic architecture of major depression. Nat Genet. 2018;50(5):668–681.CrossRefGoogle ScholarPubMed
Savage, JE, Jansen, PR, Stringer, S, et al. Genome-wide association meta-analysis in 269 867 individuals identifies new genetic and functional links to intelligence. Nat Genet. 2018;50(7):912–919.CrossRefGoogle ScholarPubMed
Stahl, EA, Breen, G, Forstner, AJ, et al. Genome-wide association study identifies 30 loci associated with bipolar disorder. Nat Genet. 2019;51(5):793–803.CrossRefGoogle ScholarPubMed
Hinrichs, KH, Easter, RE, Angers, K, et al. Influence of cognitive reserve on neuropsychological functioning in bipolar disorder: findings from a 5-year longitudinal study. Bipolar Disord. 2017;19(1):50–59.CrossRefGoogle ScholarPubMed
Bhalla, RK, Butters, MA, Zmuda, MD, et al. Does education moderate neuropsychological impairment in late-life depression? Int J Geriatr Psychiatry. 2005;20(5):413–417.CrossRefGoogle ScholarPubMed
Conus, P, Cotton, SM, Francey, SM, et al. Predictors of favourable outcome in young people with a first episode psychosis without antipsychotic medication. Schizophr Res. 2017;185:130–136.CrossRefGoogle ScholarPubMed
Brohan, E, Gauci, D, Sartorius, N, et al. Self-stigma, empowerment and perceived discrimination among people with bipolar disorder or depression in 13 European countries: the GAMIAN–Europe study. J Affect Disord. 2011;129(1–3):56–63.CrossRefGoogle ScholarPubMed
Drimer, T, Shahal, B, Barak, Y. Effects of discontinuation of long-term anticholinergic treatment in elderly schizophrenia patients. Int Clin Psychopharmacol. 2004;19(1):27–29.CrossRefGoogle ScholarPubMed
Keefe, RS, Buchanan, RW, Marder, SR, et al. Clinical trials of potential cognitive-enhancing drugs in schizophrenia: what have we learned so far? Schizophr Bull. 2013;39(2):417–435.CrossRefGoogle ScholarPubMed