Executive dysfunction in first-episode schizophrenia and relationship to duration of untreated psychosis: the West London Study.
BACKGROUND
Many studies have demonstrated early generalised cognitive impairment in schizophrenia.


OBJECTIVE
To examine executive function in first-episode schizophrenia, characterise the nature of the impairment and specify any relationships with symptoms and duration of untreated psychosis (DUP).


METHODS
Patients (n = 136) and normal controls (n = 81) were assessed with the Cambridge Automated Neuropsychological Test Battery, National Adult Reading Test IQ, and Scales for the Assessment of Positive and Negative Symptoms.


RESULTS
Memory and executive impairments in patients were independent of IQ level. Spatial working memory was impaired because of inadequate strategy use. On a planning task, patients showed reduced planning times and suboptimal problem-solving. On an attentional set-shifting task, 75% of patients were able to perform an extra-dimensional shift thought to be a core attribute of prefrontal cortex function. Those who failed had significantly longer DUP.


CONCLUSIONS
Prefrontal cortex function deteriorates at the onset of psychosis and continues to worsen over time.
Joyce
Eileen
E
Imperial College Faculty of Medicine, Charing Cross Site, St Dunstan's Road, London W6 8RP. e.joyce@ic.ac.uk
Hutton
Sam
S
Mutsatsa
Stan
S
Gibbins
Heidi
H
Webb
Emma
E
Paul
Sonja
S
Robbins
Trevor
T
Barnes
Thomas
T
D000293:Adolescent; D000328:Adult; D001288:Attention; D003072:Cognition Disorders / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D007360:Intelligence; D008297:Male; D008568:Memory; D008606:Mental Processes; D008875:Middle Aged; D011340:Problem Solving; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D012737:Sex Factors; D013997:Time Factors