Specific and Generalized Neuropsychological Deficits: A Comparison of Patients With Various First-Episode Psychosis Presentations

Jolanta Zanelli; Abraham Reichenberg; Kevin Morgan; Paul Fearon; Eugenia Kravariti; Paola Dazzan; Craig Morgan; Caroline Zanelli; Arsime Demjaha; Peter B. Jones; Gillian A. Doody; Shitij Kapur; Robin M. Murray

doi:10.1176/appi.ajp.2009.09010118

Specific and Generalized Neuropsychological Deficits: A Comparison of Patients With Various First-Episode Psychosis Presentations

Jolanta Zanelli, Abraham Reichenberg, Kevin Morgan, Paul Fearon, Eugenia Kravariti, Paola Dazzan, Craig Morgan, Caroline Zanelli, Arsime Demjaha, Peter B. Jones, Gillian A. Doody, Shitij Kapur, Robin M. Murray

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175 Citations (Scopus)

Abstract

Objective: Overwhelming evidence suggests that compromised neuropsychological function is frequently observed in schizophrenia. Neurocognitive dysfunction has often been reported in other psychotic disorders, although there are inconsistencies in the literature. In the context of four distinct diagnostic groups, the authors compared neuropsychological performance among patients experiencing their first psychotic episode. Method: Data were derived from a population-based, case-control study of patients with first-episode psychosis. A neuropsychological test battery was administered to patients with a diagnosis of schizophrenia (N=65), bipolar disorder or mania (N=37), depressive psychosis (N=39), or other psychotic disorders (N=46) following index presentation, as well as to healthy comparison subjects (N=177). The presence of specific and generalized cognitive deficits was examined. Results: The schizophrenia group presented widespread neuropsychological impairments and performed significantly worse than healthy comparison subjects on most neuropsychological measures. Patients with other psychotic disorders and depressive psychosis also demonstrated widespread impairments. Deficits in patients with bipolar disorder or mania were less pervasive but evident in performance scores on verbal memory and fluency tests. Differences between the four patient groups and healthy comparison subjects and among the patient groups were attenuated after controlling for differences in general cognitive ability (IQ). Conclusions: Early in their course, cognitive deficits are present in all psychotic disorders but are most severe and pervasive in schizophrenia and least pervasive in bipolar disorder and mania.

Original language	English
Pages (from-to)	78 - 85
Number of pages	8
Journal	The American Journal of Psychiatry
Volume	167
Issue number	1
DOIs	https://doi.org/10.1176/appi.ajp.2009.09010118
Publication status	Published - Jan 2010

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10.1176/appi.ajp.2009.09010118

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Zanelli, J., Reichenberg, A., Morgan, K., Fearon, P., Kravariti, E., Dazzan, P., Morgan, C., Zanelli, C., Demjaha, A., Jones, P. B., Doody, G. A., Kapur, S., & Murray, R. M. (2010). Specific and Generalized Neuropsychological Deficits: A Comparison of Patients With Various First-Episode Psychosis Presentations. The American Journal of Psychiatry, 167(1), 78 - 85. https://doi.org/10.1176/appi.ajp.2009.09010118

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title = "Specific and Generalized Neuropsychological Deficits: A Comparison of Patients With Various First-Episode Psychosis Presentations",

abstract = "Objective: Overwhelming evidence suggests that compromised neuropsychological function is frequently observed in schizophrenia. Neurocognitive dysfunction has often been reported in other psychotic disorders, although there are inconsistencies in the literature. In the context of four distinct diagnostic groups, the authors compared neuropsychological performance among patients experiencing their first psychotic episode. Method: Data were derived from a population-based, case-control study of patients with first-episode psychosis. A neuropsychological test battery was administered to patients with a diagnosis of schizophrenia (N=65), bipolar disorder or mania (N=37), depressive psychosis (N=39), or other psychotic disorders (N=46) following index presentation, as well as to healthy comparison subjects (N=177). The presence of specific and generalized cognitive deficits was examined. Results: The schizophrenia group presented widespread neuropsychological impairments and performed significantly worse than healthy comparison subjects on most neuropsychological measures. Patients with other psychotic disorders and depressive psychosis also demonstrated widespread impairments. Deficits in patients with bipolar disorder or mania were less pervasive but evident in performance scores on verbal memory and fluency tests. Differences between the four patient groups and healthy comparison subjects and among the patient groups were attenuated after controlling for differences in general cognitive ability (IQ). Conclusions: Early in their course, cognitive deficits are present in all psychotic disorders but are most severe and pervasive in schizophrenia and least pervasive in bipolar disorder and mania.",

author = "Jolanta Zanelli and Abraham Reichenberg and Kevin Morgan and Paul Fearon and Eugenia Kravariti and Paola Dazzan and Craig Morgan and Caroline Zanelli and Arsime Demjaha and Jones, {Peter B.} and Doody, {Gillian A.} and Shitij Kapur and Murray, {Robin M.}",

year = "2010",

month = jan,

doi = "10.1176/appi.ajp.2009.09010118",

language = "English",

volume = "167",

pages = "78 -- 85",

journal = "The American Journal of Psychiatry",

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publisher = "American Psychiatric Publishing Inc.",

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Zanelli, J, Reichenberg, A , Morgan, K , Fearon, P , Kravariti, E , Dazzan, P , Morgan, C, Zanelli, C, Demjaha, A, Jones, PB, Doody, GA, Kapur, S & Murray, RM 2010, 'Specific and Generalized Neuropsychological Deficits: A Comparison of Patients With Various First-Episode Psychosis Presentations', The American Journal of Psychiatry, vol. 167, no. 1, pp. 78 - 85. https://doi.org/10.1176/appi.ajp.2009.09010118

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T1 - Specific and Generalized Neuropsychological Deficits: A Comparison of Patients With Various First-Episode Psychosis Presentations

AU - Zanelli, Jolanta

AU - Reichenberg, Abraham

AU - Morgan, Kevin

AU - Fearon, Paul

AU - Kravariti, Eugenia

AU - Dazzan, Paola

AU - Morgan, Craig

AU - Zanelli, Caroline

AU - Demjaha, Arsime

AU - Jones, Peter B.

AU - Doody, Gillian A.

AU - Kapur, Shitij

AU - Murray, Robin M.

PY - 2010/1

Y1 - 2010/1

N2 - Objective: Overwhelming evidence suggests that compromised neuropsychological function is frequently observed in schizophrenia. Neurocognitive dysfunction has often been reported in other psychotic disorders, although there are inconsistencies in the literature. In the context of four distinct diagnostic groups, the authors compared neuropsychological performance among patients experiencing their first psychotic episode. Method: Data were derived from a population-based, case-control study of patients with first-episode psychosis. A neuropsychological test battery was administered to patients with a diagnosis of schizophrenia (N=65), bipolar disorder or mania (N=37), depressive psychosis (N=39), or other psychotic disorders (N=46) following index presentation, as well as to healthy comparison subjects (N=177). The presence of specific and generalized cognitive deficits was examined. Results: The schizophrenia group presented widespread neuropsychological impairments and performed significantly worse than healthy comparison subjects on most neuropsychological measures. Patients with other psychotic disorders and depressive psychosis also demonstrated widespread impairments. Deficits in patients with bipolar disorder or mania were less pervasive but evident in performance scores on verbal memory and fluency tests. Differences between the four patient groups and healthy comparison subjects and among the patient groups were attenuated after controlling for differences in general cognitive ability (IQ). Conclusions: Early in their course, cognitive deficits are present in all psychotic disorders but are most severe and pervasive in schizophrenia and least pervasive in bipolar disorder and mania.

AB - Objective: Overwhelming evidence suggests that compromised neuropsychological function is frequently observed in schizophrenia. Neurocognitive dysfunction has often been reported in other psychotic disorders, although there are inconsistencies in the literature. In the context of four distinct diagnostic groups, the authors compared neuropsychological performance among patients experiencing their first psychotic episode. Method: Data were derived from a population-based, case-control study of patients with first-episode psychosis. A neuropsychological test battery was administered to patients with a diagnosis of schizophrenia (N=65), bipolar disorder or mania (N=37), depressive psychosis (N=39), or other psychotic disorders (N=46) following index presentation, as well as to healthy comparison subjects (N=177). The presence of specific and generalized cognitive deficits was examined. Results: The schizophrenia group presented widespread neuropsychological impairments and performed significantly worse than healthy comparison subjects on most neuropsychological measures. Patients with other psychotic disorders and depressive psychosis also demonstrated widespread impairments. Deficits in patients with bipolar disorder or mania were less pervasive but evident in performance scores on verbal memory and fluency tests. Differences between the four patient groups and healthy comparison subjects and among the patient groups were attenuated after controlling for differences in general cognitive ability (IQ). Conclusions: Early in their course, cognitive deficits are present in all psychotic disorders but are most severe and pervasive in schizophrenia and least pervasive in bipolar disorder and mania.

U2 - 10.1176/appi.ajp.2009.09010118

DO - 10.1176/appi.ajp.2009.09010118

M3 - Article

SN - 1535-7228

VL - 167

SP - 78

EP - 85

JO - The American Journal of Psychiatry

JF - The American Journal of Psychiatry

IS - 1

ER -

Specific and Generalized Neuropsychological Deficits: A Comparison of Patients With Various First-Episode Psychosis Presentations

Abstract

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