title: Neurocognitive impairment in the deficit subtype of schizophrenia.
abstract: Schizophrenia is a heterogeneous disorder characterized by numerous diverse signs and symptoms. Individuals with prominent, persistent, and idiopathic negative symptoms are thought to encompass a distinct subtype of schizophrenia. Previous work, including studies involving neuropsychological evaluations, has supported this position. The present study sought to further examine whether deficit patients are cognitively distinct from non-deficit patients with schizophrenia. A comprehensive neurocognitive battery including tests of verbal memory, vigilance, processing speed, reasoning, and working memory was administered to 657 patients with schizophrenia. Of these, 144 (22 %) patients were classified as deficit patients using a proxy identification method based on severity, persistence over time, and possible secondary sources (e.g., depression) of negative symptoms. Deficit patients with schizophrenia performed worse on all tests of cognition relative to non-deficit patients. These patients were characterized by a generalized cognitive impairment on the order of about 0.4 standard deviations below that of non-deficit patients. However, when comparing deficit patients to non-deficit patients who also present with negative symptoms, albeit not enduring or primary, no group differences in cognitive performance were found. Furthermore, a discriminant function analysis classifying patients into deficit/non-deficit groups based on cognitive scores demonstrated only 62.3 % accuracy, meaning over one-third of individuals were misclassified. The deficit subtype of schizophrenia is not markedly distinct from non-deficit schizophrenia in terms of neurocognitive performance. While deficit patients tend to have poorer performance on cognitive tests, the magnitude of this effect is relatively modest, translating to over 70 % overlap in scores between groups.
authors.affiliation: Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Room 320, Toronto, ON, M5T 1R8, Canada. gagan.fervaha@utoronto.ca.|Institute of Medical Science, University of Toronto, Toronto, ON, Canada. gagan.fervaha@utoronto.ca.
authors.forename: Gagan
authors.initials: G
authors.lastname: Fervaha
authors.affiliation: Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Room 320, Toronto, ON, M5T 1R8, Canada.|Institute of Medical Science, University of Toronto, Toronto, ON, Canada.|Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
authors.forename: Ofer
authors.initials: O
authors.lastname: Agid
authors.affiliation: Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Room 320, Toronto, ON, M5T 1R8, Canada.|Institute of Medical Science, University of Toronto, Toronto, ON, Canada.|Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Foussias
authors.affiliation: Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Room 320, Toronto, ON, M5T 1R8, Canada.|Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
authors.forename: Ishraq
authors.initials: I
authors.lastname: Siddiqui
authors.affiliation: Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Room 320, Toronto, ON, M5T 1R8, Canada.|Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Takeuchi
authors.affiliation: Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Room 320, Toronto, ON, M5T 1R8, Canada.|Institute of Medical Science, University of Toronto, Toronto, ON, Canada.|Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
authors.forename: Gary
authors.initials: G
authors.lastname: Remington
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012559:Schizophrenia / Q000145:classification / Q000150:complications*; D012565:Schizophrenic Psychology; D018709:Statistics, Nonparametric
keywords: Amotivation; Avolition–apathy; Deficit syndrome; Neurocognition; Persistent negative symptoms; Psychotic disorder