Neurocognitive subtypes of chronic schizophrenia.
Performance on four key neurocognitive tasks was used to search for subtypes in 104 DSM-IIIR schizophrenic patients. The tasks were the Wisconsin Card Sorting Test to index executive prefrontal cerebral function, intrusion errors from the California Verbal Learning Test to tap hippocampal-diencephalic mnestic function, bilateral hand performance on the Purdue Pegboard to index fine motor-basal ganglial function, and a pro-rated IQ from the Wechsler Adult Intelligence Scale-Revised to measure general cognitive-cerebral function. Neurocognitive data were analyzed using hierarchical and disjoint clustering procedures with Euclidean distance. A five cluster solution was considered optimal. Cluster 1 (n = 24) comprised patients with selective executive-prefrontal dysfunction; cluster 2 (n = 16) suggested normative function; cluster 3 (n = 20) involved patients with executive-motor/cortico-basal ganglial deficit; cluster 4 (n = 25) suggested dementia/multi-focal disturbance; and cluster 5 (n = 19) consisted of patients with selective motor-basal ganglial deficit. The subtypes differed significantly in age, duration of illness, and extent of hospitalization. Suggestive trends in sex composition and anti-Parkinsonian medication patterns were noted. Neurocognitive tasks combined with cluster analysis have promise in reducing and clarifying the heterogeneity of schizophrenia.
Heinrichs
R W
RW
Department of Psychology, York University, North York, Ont., Canada.
Awad
A G
AG
D000328:Adult; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D016000:Cluster Analysis; D005260:Female; D005625:Frontal Lobe / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D007360:Intelligence / Q000187:drug effects / Q000502:physiology; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011594:Psychometrics; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D012565:Schizophrenic Psychology
D000978:Antiparkinson Agents; D014150:Antipsychotic Agents