Attention/vigilance in schizophrenia: performance results from a large multi-site study of the Consortium on the Genetics of Schizophrenia (COGS).
Attention/vigilance impairments are present in individuals with schizophrenia across psychotic and remitted states and in their first-degree relatives. An important question is whether deficits in attention/vigilance can be consistently and reliably measured across sites varying in many participant demographic, clinical, and functional characteristics, as needed for large-scale genetic studies of endophenotypes. We examined Continuous Performance Test (CPT) data from phase 2 of the Consortium on the Genetics of Schizophrenia (COGS-2), the largest-scale assessment of cognitive and psychophysiological endophenotypes relevant to schizophrenia. The CPT data from 2251 participants from five sites were examined. A perceptual-load vigilance task (the Degraded Stimulus CPT or DS-CPT) and a memory-load vigilance task (CPT-Identical Pairs or CPT-IP) were utilized. Schizophrenia patients performed more poorly than healthy comparison subjects (HCS) across sites, despite significant site differences in participant age, sex, education, and racial distribution. Patient-HCS differences in signal/noise discrimination (d') in the DS-CPT varied significantly across sites, but averaged a medium effect size. CPT-IP performance showed large patient-HCS differences across sites. Poor CPT performance was independent of or weakly correlated with symptom severity, but was significantly associated with lower educational achievement and functional capacity. Current smoking was associated with poorer CPT-IP d'. Patients taking both atypical and typical antipsychotic medication performed more poorly than those on no or atypical antipsychotic medications, likely reflecting their greater severity of illness. We conclude that CPT deficits in schizophrenia can be reliably detected across sites, are relatively independent of current symptom severity, and are related to functional capacity.
Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California, Los Angeles CA, United States. Electronic address: keithn@ucla.edu.
Keith H
KH
Nuechterlein
Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California, Los Angeles CA, United States; VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States.
Michael F
MF
Green
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States.
Monica E
ME
Calkins
Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States.
Tiffany A
TA
Greenwood
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States.
Raquel E
RE
Gur
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States.
Ruben C
RC
Gur
Department of Psychiatry and Behavioral Science, Stanford University, Stanford, CA, United States; Department of Pediatrics, Stanford University, Stanford, CA, United States.
Laura C
LC
Lazzeroni
Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States; VISN22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States.
Gregory A
GA
Light
Department of Psychiatry and Behavioral Science, University of Washington, Seattle, WA, United States; VA Puget Sound Healthcare System, Seattle, WA, United States.
Allen D
AD
Radant
Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, United States.
Larry J
LJ
Seidman
Department of Psychiatry, The Mount Sinai School of Medicine, New York, NY, United States; James J. Peters VA Medical Center, New York, NY, United States.
Larry J
LJ
Siever
Department of Psychiatry, The Mount Sinai School of Medicine, New York, NY, United States; James J. Peters VA Medical Center, New York, NY, United States.
Jeremy M
JM
Silverman
Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States; VISN22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States.
Joyce
J
Sprock
Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, United States.
William S
WS
Stone
Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California, Los Angeles CA, United States; VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; Department of Biostatistics, University of California, Los Angeles, CA, United States.
Catherine A
CA
Sugar
Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States.
Neal R
NR
Swerdlow
Department of Psychiatry and Behavioral Science, University of Washington, Seattle, WA, United States; VA Puget Sound Healthcare System, Seattle, WA, United States.
Debby W
DW
Tsuang
Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States; Institute for Genomic Medicine, University of California, San Diego, CA, United States; The Center for Behavioral Genomics, Department of Psychiatry, University of California, San Diego, CA, United States; Harvard Institute of Psychiatry Epidemiology and Genetics, Boston, MA, United States.
Ming T
MT
Tsuang
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States.
Bruce I
BI
Turetsky
Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States; VISN22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States.
David L
DL
Braff
D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001288:Attention; D058068:Endophenotypes; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications / Q000235:genetics / Q000503:physiopathology / Q000523:psychology*; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology; D012565:Schizophrenic Psychology; D012907:Smoking / Q000503:physiopathology / Q000523:psychology; D055815:Young Adult
D014150:Antipsychotic Agents
Attention; Cognition; Continuous Performance Test; Endophenotype; Functional capacity; Genetics; Schizophrenia