Correlating cognitive functions to symptom domains and insight in Egyptian patients with schizophrenia

Abstract

Introduction: Cognitive impairment is one of the fundamental features among patients with schizophrenia. The relationship between schizophrenia symptoms, insight and cognitive domains remains controversial. We aimed to study these relations in a sample of Egyptian patients with schizophrenia. Methods: A total of 109 patients with schizophrenia were assessed using Structured Clinical Interview for DSM-IV ( Diagnostic and Statistical Manual of Mental Disorders (4th ed.)) Axis I diagnosis (SCID-I), Positive and Negative Syndrome Scale (PANSS) and Scale to Assess Unawareness of Medical Disorder (SUMD). Cognitive functions were assessed using the Wechsler Adult Intelligence Scale (WAIS), the Wisconsin Card Sorting Test (WCST) and the Wechsler Memory Scale (WMS). The cognitive functions would be distributed to cover six cognitive domains: attention/vigilance speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. Results: There was a significant correlation between all cognitive domains (except attention) and PANSS subscales. PANSS negative and general psychopathology subscales were significantly correlated with five cognitive domains: speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. PANSS negative subscale was significantly correlated with verbal learning (verbal paired association 1) and visual learning (visual paired association 1). There was a significant correlation between all cognitive domains and SUMD, except verbal and visual learning domains assessed by verbal and visual paired association 1 subtests, as well as attention assessed by failure to maintain set subtest. Only visual learning (trials administered), working memory (percentage error), and processing speed (perseverative responses, and trials to complete first category) were significantly negatively correlated to SUMD. Conclusion: Cognitive impairment in patients with schizophrenia is most likely to underlie negative symptoms, general psychopathology symptoms and poor insight, suggesting that treatment strategies minimizing these symptoms would improve cognitive impairment.

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“…These tests evaluated the three main cognitive domains: memory, executive function and processing speed. The Wechsler Memory Scale (WMS-IV) was used to test learning of verbal paired associates (immediate and delayed memory and recognition) [16,17]. The Wechsler Adult Intelligence Scale (WAIS) was used to measure working memory (Digit Span and Letter-Number Sequencing (LNS) by WAIS-III and WAIS-IV, respectively) and perceptual reasoning (matrix) (WAIS-IV), and the Trail Making Test (TMT) was used to measure cognitive flexibility and visual-motor processing speed [18e20] in a quiet room.…”

Atypical frontotemporal cortical activity in first-episode adolescent-onset schizophrenia during verbal fluency task: A functional near-infrared spectroscopy study

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Cold executive function processes and their hot analogs in schizotypy

“…The finding of impoverished working memory and reduced response inhibition, two highly interconnected cognitive processes (Bissett et al, 2022), is in direct agreement with previous findings in the schizotypy literature (Ettinger et al, 2018; Karagiannopoulou et al, 2016; Karamaouna et al, 2021; Matheson & Langdon, 2008; Park & McTigue, 1997). It is also supported by evidence from (a) neuroimaging studies indicating commonalities in the neural substrate between the three constructs (Emch et al, 2019; Kühn et al, 2012; Pfarr & Nenadić, 2020; Sutcliffe et al, 2016; Wiebels et al, 2016) and (b) studies linking the negative symptom cluster of schizophrenia symptoms with both cognitive processes (e.g., Bora & Murray, 2014; Gotra et al, 2020; Khalil et al, 2020; Shin et al, 2013) as well as schizotypal personality disorder symptoms with impairments in working memory (Mitropoulou et al, 2002, 2005; Rosell et al, 2014). The finding that negative schizotypes performed worse in the affective Stroop task compared to controls is interesting, given that there were no group differences in this group on the classical version of the task or in affective working memory, affective response inhibition or affective DM.…”