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Am J Psychiatry 1993; 150:1355-1362
Copyright © 1993 by American Psychiatric Association
Contrasts between patients with affective disorders and patients with schizophrenia on a neuropsychological test battery
TE Goldberg, JM Gold, R Greenberg, S Griffin, SC Schulz, D Pickar, JE Kleinman and DR Weinberger
Clinical Brain Disorders Branch, NIMH Neuroscience Center at St. Elizabeths, Washington, DC 20032.
OBJECTIVE: This study was designed to ascertain the degree and specificity
of cognitive impairments in patients with schizophrenia and patients with
affective disorders. METHOD: Cognitive function was assessed with a
neuropsychological test battery in consecutively admitted patients with
schizophrenia (N = 57), unipolar depression (N = 29), and bipolar disorder
(N = 16). RESULTS: The performance of the schizophrenic group was
significantly below that of the groups with affective disorders on measures
of attention and psychomotor speed, verbal and visual memory, and problem
solving and abstraction. IQ was lower in the schizophrenic group and
appeared to have deteriorated from a normal premorbid level that was not
different from that of the affective disorder groups, as determined by the
Wide Range Achievement Test--Revised reading test, a putative measure of
premorbid intelligence. When IQ was controlled, differences between the
groups in problem solving and visual memory remained. Psychiatric symptoms
had a larger impact on test performance in the affective disorder groups
than in the schizophrenic group. CONCLUSIONS: These results suggest that
patients with schizophrenia perform systematically worse on cognitive
measures than patients with affective disorders, which is consistent with
their generally poorer outcome. The results also indicate that
schizophrenia and affective disorders are qualitatively distinguishable in
neuropsychological terms, given differences in apparent intellectual
deterioration, profiles of cognitive impairment, and associations between
cognitive performance and psychopathology.
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