title: A six-factor model of cognition in schizophrenia and related psychotic disorders: relationships with clinical symptoms and functional capacity.
abstract: Confirmatory factor analysis was used to examine a proposed factor structure of a comprehensive neuropsychological battery used to study patients with schizophrenia and related psychotic disorders (n = 209). An a priori six-factor model and five nested models were evaluated successively, using maximum likelihood confirmatory factor analysis. In all multifactor models, the factors were significantly intercorrelated. A six-factor model with two pairs of correlated errors fit the neuropsychological data significantly better than competing models with fewer factors. The six factors included verbal crystallized, attention/working memory, verbal episodic memory, speed of information processing, visual episodic memory, and reasoning/problem solving. Severity of negative symptoms was significantly associated with worse performance on attention/working memory and verbal crystallized factors, but positive symptoms, depression, and a summary measure of psychopathology were not significantly related to neuropsychological performance. Impairment on a performance-based measure of functional capacity was significantly related to all neuropsychological factors. A simultaneous confirmatory factor analysis using the original sample and a group of healthy subjects (n = 131) demonstrated that the six-factor model of cognition was generalizable and applied equally well to both groups.
authors.affiliation: Department of Psychiatry, University of California, San Diego 92161, USA.
authors.forename: Julie Akiko
authors.initials: JA
authors.lastname: Gladsjo
authors.forename: Lou Ann
authors.initials: LA
authors.lastname: McAdams
authors.forename: Barton W
authors.initials: BW
authors.lastname: Palmer
authors.forename: David J
authors.initials: DJ
authors.lastname: Moore
authors.forename: Dilip V
authors.initials: DV
authors.lastname: Jeste
authors.forename: Robert K
authors.initials: RK
authors.lastname: Heaton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use; D010054:Brief Psychiatric Rating Scale; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005163:Factor Analysis, Statistical; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012559:Schizophrenia / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation; D012720:Severity of Illness Index
chemical_list: D014150:Antipsychotic Agents