title: Relationship of neurocognitive deficits to diagnosis and symptoms across affective and non-affective psychoses.
abstract: BACKGROUND
  Neurocognitive dysfunction is believed to be a core feature of schizophrenia and is increasingly recognized as a common symptom dimension in bipolar disorder. Despite a copious literature on neurocognition in these disorders, the relationship amongst neurocognition, symptoms, and diagnosis remains unclear. We examined neurocognitive functioning in a cross-diagnostic sample of patients with psychotic disorders. Based on previous findings, it was hypothesized that neurocognitive functioning would be impaired in all three patient groups, and that groups would be similarly impaired on all neuropsychological measures. Additionally, we predicted that negative symptoms but not positive, general, or mood symptoms, would be associated with neurocognitive functioning.
  
  
  METHODS
  Neurocognitive functioning and symptoms were assessed in participants with schizophrenia (n=25), schizoaffective disorder (n=29), or bipolar disorder with psychosis (n=31), and in healthy controls (n=20).
  
  
  RESULTS
  Neurocognitive functioning was significantly impaired in all patient groups, and groups did not differ by diagnosis on most measures. A series of linear regressions revealed that negative symptoms (but no other clinical symptom) predicted poorer executive functioning across groups. Diagnosis was not a significant predictor of any neurocognitive variable.
  
  
  CONCLUSIONS
  Neurocognitive deficits were pronounced in this cross-diagnostic sample of patients with psychotic disorders, and did not differ by diagnosis. Neurocognitive dysfunction may represent a symptom dimension that spans diagnostic categories, and may reflect shared pathogenic processes. As neurocognitive dysfunction is among the strongest predictors of outcome in patients, efforts to treat these deficits, which have shown promise in schizophrenia, should be extended to all patients with psychosis.
authors: Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA, 02478 USA. klewandowski@mclean.harvard.edu
authors: Kathryn E
authors: KE
authors: Lewandowski
authors: Bruce M
authors: BM
authors: Cohen
authors: Matcheri S
authors: MS
authors: Keshavan
authors: Dost
authors: D
authors: Ongür
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000150:complications*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications*; D012559:Schizophrenia / Q000150:complications*; D055815:Young Adult