title: Profiling cognitive impairment in treatment-resistant schizophrenia patients.
abstract: The aim of this study was to compare cognitive performance between schizophrenia patients with and without treatment resistance (TRS and non-TRS patients) taking into account psychopathological symptoms and antipsychotic treatment. The following cognitive tests were administered to 53 TRS patients and 32 non-TRS subjects: Rey Auditory Verbal Learning Test (RAVLT), Trail Making Tests (TMT-A and TMT-B), verbal fluency tests (FAS test and Supermarket), as well as selected Wechsler Adults Intelligence Scale (WAIS-R-PI) subtests: Digit Symbol Coding Test, Digit Span Forward and Backward and Similarities. TRS patients performed significantly worse in comparison with non-TRS patients on the measures of processing speed (TMT-A, Stroop test, FAS test, Supermarket test, Digit Symbol Coding test), verbal fluency (FAS test, Supermarket test), cognitive flexibility and executive functions (Stroop test) after controlling for age, illness duration, clinical symptoms severity, the number of years of completed education and antipsychotics' dose. Cognitive performance was associated with negative and general symptomatology. Anticholinergic activity of antipsychotics had debilitating effect on cognitive functioning in non-TRS patients (FAS test) and in TRS patients (TMT-B test, Stroop test, RAVLT subtests, Digit Coding test and Similarities test), while low anticholinergic activity of antipsychotics was associated with better cognitive performance in non-TRS patients (Backward Digit Span test) and in TRS patients (Similarities test). Results of this study indicate that cognitive deficits are more robust in TRS patients than in non-TRS subjects, and are associated with clinical symptoms as well as the treatment with antipsychotics that exert high anticholinergic activity.
authors.affiliation: Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland. Electronic address: dfrydecka@gmail.com.
authors.forename: Dorota
authors.initials: D
authors.lastname: Frydecka
authors.affiliation: Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland.
authors.forename: Jan Aleksander
authors.initials: JA
authors.lastname: Beszłej
authors.affiliation: Lower Silesian Centre of Mental Health, 18 Conrad Korzeniowski Street, 50-226 Wroclaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Gościmski
authors.affiliation: Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kiejna
authors.affiliation: Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367 Wroclaw, Poland; Department of Genetics, Wroclaw Medical University, 1 Marcinkowski Street, 50-368 Wroclaw, Poland.
authors.forename: Błażej
authors.initials: B
authors.lastname: Misiak
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000494:pharmacology; D018680:Cholinergic Antagonists / Q000009:adverse effects* / Q000494:pharmacology; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000139:chemically induced / Q000523:psychology*; D056344:Executive Function / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011599:Psychopathology; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D057190:Stroop Test; D014145:Trail Making Test; D014706:Verbal Learning; D014888:Wechsler Scales
chemical_list: D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists
keywords: Anticholinergic effect; Antipsychotics; Cognition; Schizophrenia; Treatment resistance