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Is there change in intelligence quotient in chronically ill schizophrenia patients? A longitudinal study in twins discordant for schizophrenia

Published online by Cambridge University Press:  13 April 2012

A. M. Hedman ,
N. E. M. van Haren ,
G. C. M. van Baal ,
R. G. H. Brans ,
R. Hijman ,
R. S. Kahn  and
H. E. Hulshoff Pol
A. M. Hedman*
Affiliation:
Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical CenterUtrecht, The Netherlands
N. E. M. van Haren
Affiliation:
Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical CenterUtrecht, The Netherlands
G. C. M. van Baal
Affiliation:
Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical CenterUtrecht, The Netherlands
R. G. H. Brans
Affiliation:
Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical CenterUtrecht, The Netherlands
R. Hijman
Affiliation:
Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical CenterUtrecht, The Netherlands
R. S. Kahn
Affiliation:
Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical CenterUtrecht, The Netherlands
H. E. Hulshoff Pol
Affiliation:
Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical CenterUtrecht, The Netherlands
*
*Address for correspondence: A. M. Hedman, M.Sc., Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, A.01.126, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. (Email: A.Hedman@umcutrecht.nl)
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Abstract

Background

Intellectual deficits are commonly found in schizophrenia patients. These intellectual deficits have been found to be heritable. However, whether the intellectual deficits change over time and, if so, whether the change is related with an increased genetic risk for the disease are not known.

Method

We investigated change of intelligence quotient (IQ) in a twin sample of chronically ill schizophrenia patients, the discordant co-twins and healthy controls during a follow-up period of 5 years. A total of 52 twins completed two IQ assessments: nine patients [three monozygotic (MZ) and six dizygotic (DZ)], 10 unaffected co-twins (three MZ and seven DZ) and 33 healthy control twins (21 MZ and 12 DZ).

Results

A significant interaction effect over time was found between IQ measurement and illness (F=4.22, df=1, p<0.05), indicating that change in IQ over time is significantly different between the groups. A stable course in IQ over time was found in the patients with schizophrenia (mean IQ from 109.78 at baseline to 108.44 at follow-up) relative to both the healthy control twins who showed a small increase (from 114.61 at baseline to 119.18 at follow-up) (t=2.06, p<0.05) and the unaffected co-twins (from 111.60 to 117.60, t=−2.32, p<0.05). IQ change in the unaffected co-twins of schizophrenia patients was comparable with that in healthy control twins (t=−0.49, p=0.63).

Conclusions

Patients with schizophrenia in the chronic phase of the disease, but not the discordant co-twins, show a lack of increase in IQ, which is probably due to environmental (non-genetic) factors related to the disease.

Keywords

IQlongitudinalschizophreniatwins
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 12 , December 2012 , pp. 2535 - 2541
Copyright
Copyright © Cambridge University Press 2012

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References

Baaré, WF, van Oel, CJ, Hulshoff Pol, HE, Schnack, HG, Durston, S, Sitskoorn, MM, Kahn, RS (2001). Volumes of brain structures in twins discordant for schizophrenia. Archives of General Psychiatry 58, 33–40.CrossRefGoogle ScholarPubMed
Bedwell, JS, Keller, B, Smith, AK, Hamburger, S, Kumra, S, Rapoport, JL (1999). Why does postpsychotic IQ decline in childhood-onset schizophrenia? American Journal of Psychiatry 156, 1996–1997.CrossRefGoogle ScholarPubMed
Brans, RG, van Haren, NE, van Baal, GC, Schnack, HG, Kahn, RS, Hulshoff Pol, HE (2008). Heritability of changes in brain volume over time in twin pairs discordant for schizophrenia. Archives of General Psychiatry 65, 1259–1268.CrossRefGoogle ScholarPubMed
Brodaty, H, Sachdev, P, Koschera, A, Monk, D, Cullen, B (2003). Long-term outcome of late-onset schizophrenia: 5-year follow-up study. British Journal of Psychiatry 183, 213–219.CrossRefGoogle ScholarPubMed
Carter, JW, Parnas, J, Urfer-Parnas, A, Watson, J, Mednick, SA (2010). Intellectual functioning and the long-term course of schizophrenia-spectrum illness. Psychological Medicine. Published online 22 September 2010. doi:10.1017/S0033291710001820.Google ScholarPubMed
Censits, DM, Ragland, JD, Gur, RC, Gur, RE (1997). Neuropsychological evidence supporting a neurodevelopmental model of schizophrenia: a longitudinal study. Schizophrenia Research 24, 289–298.CrossRefGoogle ScholarPubMed
Cervellione, KL, Birdick, KE, Cottone, JD, Rhinewine, JP, Kumra, S (2007). Neurocognitive deficits in adolescents with schizophrenia: longitudinal stability and predictive utility for short-term functional outcome. Journal of the American Academy of Child and Adolescent Psychiatry 46, 867–878.CrossRefGoogle ScholarPubMed
Davidson, M, Galderisi, S, Weiser, M, Werbeloff, N, Fleischhacker, WW, Keefe, RS, Boter, H, Keet, IP, Prelipceanu, D, Rybakowski, JK, Libiger, J, Hummer, M, Dollfus, S, López-Ibor, JJ, Hranov, LG, Gaebel, W, Peuskens, J, Lindefors, N, Riecher-Rössler, A, Kahn, RS (2009). Cognitive effects of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: a randomized, open-label clinical trial (EUFEST). American Journal of Psychiatry 166, 675–682.CrossRefGoogle ScholarPubMed
Friedman, JI, Harvey, PD, Coleman, T, Moriarty, PJ, Bowie, C, Parrella, M, White, L, Adler, D, Davis, KL (2001). Six-year follow-up study of cognitive and functional status across the lifespan in schizophrenia: a comparison with Alzheimer's disease and normal aging. American Journal of Psychiatry 158, 1441–1448.CrossRefGoogle ScholarPubMed
Gochman, PA, Greenstein, D, Sporn, A, Gogtay, N, Keller, B, Shaw, P, Rapoport, JL (2005). IQ stabilization in childhood-onset schizophrenia. Schizophrenia Research 15, 271–277.CrossRefGoogle Scholar
Gold, S, Arndt, S, Nopoulos, P, O'Leary, DS, Andreasen, NC (1999). Longitudinal study of cognitive function in first-episode and recent-onset schizophrenia. American Journal of Psychiatry 156, 1342–1348.CrossRefGoogle ScholarPubMed
Green, MF, Marder, SR, Glynn, SM, McGurk, SR, Wirshing, WC, Wirshing, DA, Liberman, RP, Mintz, J (2002). The neurocognitive effects of low-dose haloperidol: a two-year comparison with risperidone. Biological Psychiatry 51, 972–978.CrossRefGoogle ScholarPubMed
Hamlin, RM (1969). The stability of intellectual function in chronic schizophrenia. Journal of Nervous and Mental Disease 149, 496–503.CrossRefGoogle ScholarPubMed
Haywood, HC, Moelis, I (1963). Effect of symptom change on intellectual function in schizophrenia. Journal of Abnormal and Social Psychology 67, 76–78.CrossRefGoogle ScholarPubMed
Heaton, RK, Gladsjo, JA, Palmer, BW, Kuck, J, Marcotte, TD, Jeste, DV (2001). Stability and course of neuropsychological deficits in schizophrenia. Archives of General Psychiatry 58, 24–32.CrossRefGoogle ScholarPubMed
Hijman, R, Hulshoff Pol, HE, Sitskoorn, MM, Kahn, RS (2003). Global intellectual impairment does not accelerate with age in patients with schizophrenia: a cross-sectional analysis. Schizophrenia Bulletin 29, 509–517.CrossRefGoogle Scholar
Hiscock, M (2007). The Flynn effect and its relevance to neuropsychology. Journal of Clinical and Experimental Neuropsychology 29, 514–529.CrossRefGoogle ScholarPubMed
Hoff, AL, Sakuma, M, Wieneke, M, Horon, R, Kushner, M, DeLisi, LE (1999). Longitudinal neuropsychological follow-up study of patients with first-episode schizophrenia. American Journal of Psychiatry 156, 1336–1341.CrossRefGoogle ScholarPubMed
Hoff, AL, Svetina, C, Shields, G, Stewart, J, DeLisi, LE (2005). Ten year longitudinal study of neuropsychological functioning subsequent to a first episode of schizophrenia. Schizophrenia Research 78, 27–34.CrossRefGoogle ScholarPubMed
Hulshoff Pol, HE, Brans, RG, van Haren, NE, Schnack, HG, Langen, M, Baaré, WF, van Oel, CJ, Kahn, RS (2004). Gray and white matter volume abnormalities in monozygotic and same-gender dizygotic twins discordant for schizophrenia. Biological Psychiatry 55, 126–130.CrossRefGoogle ScholarPubMed
Hulshoff Pol, HE, Schnack, HG, Mandl, RC, Brans, RG, van Haren, NE, Baaré, WF, van Oel, CJ, Collins, DL, Evans, AC, Kahn, RS (2006). Gray and white matter density changes in monozygotic and same-sex dizygotic twins discordant for schizophrenia using voxel-based morphometry. Neuroimage 31, 482–488.CrossRefGoogle ScholarPubMed
Irani, F, Kalkstein, S, Moberg, EA, Moberg, PJ (2011). Neuropsychological performance in older patients with schizophrenia: a meta-analysis of cross-sectional and longitudinal studies. Schizophrenia Bulletin 37, 1318–1326.CrossRefGoogle ScholarPubMed
Jepsen, JR, Fagerlund, B, Pagsberg, AK, Christensen, AM, Hilker, RW, Nordentoft, M, Mortensen, EL (2010). Course of intelligence deficits in early onset, first episode schizophrenia: a controlled, 5-year longitudinal study. European Child and Adolescent Psychiatry 19, 341–351.CrossRefGoogle ScholarPubMed
Kay, SR, Fiszbein, A, Opler, LA (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261–276.CrossRefGoogle ScholarPubMed
Keefe, RS, Bilder, RM, Davis, SM, Harvey, PD, Palmer, BW, Gold, JM, Meltzer, HY, Green, MF, Capuano, G, Stroup, TS, McEvoy, JP, Swartz, MS, Rosenheck, RA, Perkins, DO, Davis, CE, Hsiao, JK, Lieberman, JA (2007). CATIE Investigators; Neurocognitive Working Group. Neurocognitive effects of antipsychotic medications in patients with chronic schizophrenia in the CATIE Trial. Archives of General Psychiatry 64, 633–647.Google Scholar
Keefe, RS, Fenton, WS (2007). How should DSM-V criteria for schizophrenia include cognitive impairment? Schizophrenia Bulletin 33, 912–920.CrossRefGoogle ScholarPubMed
Klonoff, H, Fibiger, CH, Hutton, GH (1970). Neuropsychological patterns in chronic schizophrenia. Journal of Nervous and Mental Disease 150, 291–300.CrossRefGoogle ScholarPubMed
Kørner, A, Lopez, AG, Lauritzen, L, Andersen, PK, Kessing, LV (2009). Late and very-late first-contact schizophrenia and the risk of dementia – a nationwide register based study. International Journal of Geriatric Psychiatry 24, 61–67.CrossRefGoogle ScholarPubMed
Kraepelin, E (1919). Dementia Praecox and Paraphrenia. E & S Livingstone: Edinburgh.Google Scholar
Mockler, D, Riordan, J, Sharma, T (1997). Memory and intellectual deficits do not decline with age in schizophrenia. Schizophrenia Research 26, 1–7.CrossRefGoogle Scholar
Nayak Savla, G, Moore, DJ, Roesch, SC, Heaton, RK, Jeste, DV, Palmer, BW (2006). An evaluation of longitudinal neurocognitive performance among middle-aged and older schizophrenia patients: use of mixed-model analyses. Schizophrenia Research 83, 215–223.CrossRefGoogle ScholarPubMed
Posthuma, D, de Geus, EJ, Boomsma, DI (2001). Perceptual speed and IQ are associated through common genetic factors. Behavior Genetics 31, 593–602.CrossRefGoogle ScholarPubMed
Rapport, LJ, Brines, DB, Axelrod, BN, Theisen, ME (1997). Full scale IQ as mediator of practice effects: the rich get richer. Clinical Neuropsychology 11, 375–380.CrossRefGoogle Scholar
Rollnik, JD, Borsutzky, M, Huber, TJ, Mogk, H, Seifert, J, Emrich, HM, Schneider, U (2002). Short-term cognitive improvement in schizophrenics treated with typical and atypical neuroleptics. Neuropsychobiology 45, 74–80.CrossRefGoogle ScholarPubMed
Russel, AJ, Munro, JC, Jones, PB, Hemsley, DR, Murray, RM (1997). Schizophrenia and the myth of intellectual decline. American Journal of Psychiatry 154, 635–639.Google Scholar
Salthouse, TA (2010). Influence of age on practice effects in longitudinal neurocognitive change. Neuropsychology 24, 563–572.CrossRefGoogle ScholarPubMed
Sheitman, BB, Murray, MG, Snyder, JA, Silva, S, Goldman, R, Chakos, M, Volavka, J, Lieberman, JA (2000). IQ scores of treatment-resistant schizophrenia patients before and after the onset of the illness. Schizophrenia Research 46, 203–207.CrossRefGoogle ScholarPubMed
Smith, A (1964). Mental deterioration in chronic schizophrenia. Journal of Nervous and Mental Disease 139, 479–487.CrossRefGoogle ScholarPubMed
Stinissen, J, Willems, PJ, Coetsier, P, Hulsman, WLL (1970). Manual of the Dutch Translation of the Wechsler Adult Intelligence Scale. Swets: Amsterdam.Google Scholar
Stirling, J, White, C, Lewis, S, Hopkins, R, Tantam, D, Huddy, A, Montague, L (2003). Neurocognitive function and outcome in first-episode schizophrenia: a 10-year follow-up of an epidemiological cohort. Schizophrenia Research 65, 75–86.CrossRefGoogle ScholarPubMed
Toulopoulou, T, Picchioni, M, Rijsdijk, F, Hua-Hall, M, Ettinger, U, Sham, P, Murray, R (2007). Substantial genetic overlap between neurocognition and schizophrenia: genetic modeling in twin samples. Archives of General Psychiatry 64, 1348–1355.CrossRefGoogle ScholarPubMed
van Winkel, R, Myin-Germeys, I, Delespaul, P, Peuskens, J, De Hert, M, van Os, J (2006). Premorbid IQ as a predictor for the course of IQ in first onset patients with schizophrenia: a 10-year follow-up study. Schizophrenia Research 88, 47–54.CrossRefGoogle ScholarPubMed
Zipparo, L, Whitford, TJ, Redoblado Hodge, MA, Lucas, S, Farrow, TF, Brennan, J, Gomes, L, Williams, LM, Harris, AW (2008). Investigating the neuropsychological and neuroanatomical changes that occur over the first 2–3 years of illness in patients with first-episode schizophrenia. Progress in Neuro-Psychopharmacology and Biological Psychiatry 32, 531–538.CrossRefGoogle ScholarPubMed