Is Clinical Insight Associated with Working Memory Components in Schizophrenia and Schizoaffective Disorder?

Tümkaya, Selim; Yenigün, Ezgi Hanci; Topak, Osman Zülkif; Şendur, İbrahim; Atkaya, Neşe Öztürk; Özdel, Osman

doi:10.5080/u22878

Cited by 2 publications

(2 citation statements)

References 2 publications

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“…Sustained attention has been previously linked to unawareness of illness in SZH 32 , 33 . Although not found here, other studies have linked better executive function (measured by WCST perseverative errors) 30 and visual working memory (measured by a visual tracking test called the Situational Awareness Test) 51 to higher insight. Lysaker et al 52 suggest that attention impairments, alongside deficits in memory and executive function, undermine a patient’s abilities to retrieve, integrate and reflect on relevant information: insight requires being able to recognise and make links between experiences salient to the illness, and poorer attention could undermine this.…”

Section: Discussioncontrasting

confidence: 58%

Relationships between cognitive performance, clinical insight and regional brain volumes in schizophrenia

Alkan

Evans

2022

Schizophr

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Impairments in cognitive performance are common in schizophrenia, and these contribute to poor awareness of symptoms and treatment (‘clinical insight’), which is an important predictor of functional outcome. Although relationships between cognitive impairment and reductions in regional brain volumes in patients are relatively well characterised, less is known about the brain structural correlates of clinical insight. To address this gap, we aimed to explore brain structural correlates of cognitive performance and clinical insight in the same sample. 108 patients with schizophrenia (SZH) and 94 age and gender-matched controls (CON) (from the Northwestern University Schizophrenia Data and Software Tool (NUSDAST) database) were included. SZH had smaller grey matter volume across most fronto-temporal regions and significantly poorer performance on all cognitive domains. Multiple regression showed that higher positive symptoms and poorer attention were significant predictors of insight in SZH; however, no significant correlations were seen between clinical insight and regional brain volumes. In contrast, symptomology did not contribute to cognitive performance, but robust positive relationships were found between regional grey matter volumes in fronto-temporal regions and cognitive performance (particularly executive function). Many of these appeared to be unique to SZH as they were not observed in CON. Findings suggest that while there exists a tight link between cognitive functioning and neuropathological processes affecting gross brain anatomy in SZH, this is not the case for clinical insight. Instead, clinical insight levels seem to be influenced by symptomology, attentional performance and other subject-specific variables.

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Section: Discussioncontrasting

confidence: 58%

Relationships between cognitive performance, clinical insight and regional brain volumes in schizophrenia

Alkan

Evans

2022

Schizophr

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“…Before the test, each participant reads the instructions. This task has previously been used to assess executive functions in schizophrenia [59,60]. Based on Polgár et al [61], we measured two components of executive functions: concept formation using percent of perseverative errors (PPE) and problem-solving using the percent of non-perseverative errors (PNPE).…”

Section: Berg Card Sorting Testmentioning

confidence: 99%

Executive Functions and Psychopathology Dimensions in Deficit and Non-Deficit Schizophrenia

Bielecki

Tyburski

Plichta

et al. 2023

JCM

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This study: (a) compared executive functions between deficit (DS) and non-deficit schizophrenia (NDS) patients and healthy controls (HC), controlling premorbid IQ and level of education; (b) compared executive functions in DS and NDS patients, controlling premorbid IQ and psychopathological symptoms; and (c) estimated relationships between clinical factors, psychopathological symptoms, and executive functions using structural equation modelling. Participants were 29 DS patients, 44 NDS patients, and 39 HC. Executive functions were measured with the Mazes Subtest, Spatial Span Subtest, Letter Number Span Test, Color Trail Test, and Berg Card Sorting Test. Psychopathological symptoms were evaluated with the Positive and Negative Syndrome Scale, Brief Negative Symptom Scale, and Self-evaluation of Negative Symptoms. Compared to HC, both clinical groups performed poorer on cognitive flexibility, DS patients on verbal working memory, and NDS patients on planning. DS and NDS patients did not differ in executive functions, except planning, after controlling premorbid IQ and negative psychopathological symptoms. In DS patients, exacerbation had an effect on verbal working memory and cognitive planning; in NDS patients, positive symptoms had an effect on cognitive flexibility. Both DS and NDS patients presented deficits, affecting the former to a greater extent. Nonetheless, clinical variables appeared to significantly affect these deficits.

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Is Clinical Insight Associated with Working Memory Components in Schizophrenia and Schizoaffective Disorder?

Cited by 2 publications

References 2 publications

Relationships between cognitive performance, clinical insight and regional brain volumes in schizophrenia

Relationships between cognitive performance, clinical insight and regional brain volumes in schizophrenia

Executive Functions and Psychopathology Dimensions in Deficit and Non-Deficit Schizophrenia

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