Do specific neurocognitive deficits predict specific domains of community function in schizophrenia?
We examined whether specific neurocognitive deficits predicted specific domains of community outcome in 40 schizophrenic patients. Neuropsychological assessments were conducted before hospital discharge, and measures of functional outcome were obtained 1 to 3.5 years later. A priori hypotheses were generated based upon a recent review by Green (Green MF [1996] What are the functional consequences of neurocognitive deficits in schizophrenia? American Journal of Psychiatry, 153(3):321-330). As hypothesized, verbal memory predicted all measures of community outcome, vigilance predicted social outcomes, and executive functioning predicted work and activities of daily living (ADLs). However, in addition to the predicted relationships, many other associations were found between neuropsychological test scores and adaptive function. Furthermore, both cognitive and functional measures were intercorrelated. If deficits in adaptive functioning are neurocognitively multi-determined, utilizing compensatory strategies to bypass multiple areas of cognitive impairment may be more efficient than cognitive remediation in improving community outcomes.
Velligan
D I
DI
Department of Psychiatry, The University of Texas Health Science Center at San Antonio, 78229-3900, USA.
Bow-Thomas
C C
CC
Mahurin
R K
RK
Miller
A L
AL
Halgunseth
L C
LC
D000203:Activities of Daily Living; D000328:Adult; D002908:Chronic Disease; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012044:Regression Analysis; D012559:Schizophrenia / Q000175:diagnosis* / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D012917:Social Adjustment