Sustained attention and planning deficits but intact attentional set-shifting in neuroleptic-naïve first-episode schizophrenia patients.
BACKGROUND
The nature of deficits in tests of sustained attention, planning and attentional set-shifting has not been investigated in neuroleptic-naïve first-episode (FE) schizophrenia patients. Based on previous literature of chronic and medicated FE schizophrenia patients, we predicted that the neuroleptic-naïve patients would show deficits in these cognitive processes.


METHODS
Twenty-nine neuroleptic-naïve FE schizophrenia patients and 33 healthy controls - matched by age, gender, and nicotine consumption - performed 3 tests from the Cambridge Automated Neuropsychological Test Battery (CANTAB) thought to measure these cognitive processes: the Rapid Visual Information Processing task (RVIP, sustained attention), the Stockings of Cambridge task (SOC, planning), and the Intradimensional/Extradimensional set-shifting task (IDED, attention shifting).


RESULTS
The patients were significantly impaired in the sensitivity index (A') of the RVIP, and in the number of problems solved with minimum moves on the SOC. Nevertheless, the groups did not differ regarding the number of participants who failed at the crucial extradimensional shift stage of the IDED.


CONCLUSIONS
Sustained attention and planning abilities are already impaired in neuroleptic-naïve FE schizophrenia patients, whereas set-shifting abilities as measured with the IDED task seem to be intact at illness onset. Since chronic schizophrenia patients have been shown to have impaired IDED performance, we tentatively propose that IDED performance deteriorates over time with illness chronicity and/or medication.
Hilti
Caroline C
CC
Research Department, Psychiatric Services Aargau, Brugg, Switzerland. caroline.hilti @ puk.unibe.ch
Delko
Tarik
T
Orosz
Ariane T
AT
Thomann
Kathrin
K
Ludewig
Stephan
S
Geyer
Mark A
MA
Vollenweider
Franz X
FX
Feldon
Joram
J
Cattapan-Ludewig
Katja
K
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011340:Problem Solving / Q000502:physiology*; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D012680:Sensitivity and Specificity; D012718:Set, Psychology; D013223:Statistics as Topic; D014796:Visual Perception / Q000502:physiology; D055815:Young Adult