Hostname: page-component-8448b6f56d-c47g7 Total loading time: 0 Render date: 2024-04-19T06:19:19.065Z Has data issue: false hasContentIssue false
  • English
  • Français

Executive functioning and psychopathological profile in relatives of individuals with deficit v. non-deficit schizophrenia: a pilot study

Published online by Cambridge University Press:  02 April 2013

S. Scala ,
A. Lasalvia ,
L. J. Seidman ,
D. Cristofalo ,
C. Bonetto  and
M. Ruggeri
S. Scala
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy Harvard Medical School, Department of Psychiatry, Massachusetts Mental Health Center Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
A. Lasalvia*
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
L. J. Seidman
Affiliation:
Harvard Medical School, Department of Psychiatry, Massachusetts Mental Health Center Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
D. Cristofalo
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
C. Bonetto
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
M. Ruggeri
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Verona, Italy
*
*Address for correspondence: Dr A. Lasalvia, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, P.le L.A. Scuro, 10, 37134 Verona, Italy. (Email: antonio.lasalvia@univr.it)
Get access Rights & Permissions [Opens in a new window]

Abstract

Aims.

Heterogeneity of schizophrenia is known to be reflected in neuropsychological functioning of patients, but its expression in relatives is understudied. This study aims at exploring relationship between executive functioning and clinical profiles of first-degree relatives of patients who are classified as having or not having the deficit subtype of schizophrenia (DSRELs v. non-DSRELs), with the prediction of greater executive impairment in DSRELs.

Methods.

DSRELs (n = 15) and non-DSRELs (n = 40) were compared with community controls (CCs, n = 55) on executive functioning measured by the Wisconsin Card Sorting Test (WCST) and the phonemic verbal fluency (PVF), and clinical measures. Effects of psychopathology and intelligence quotient (IQ) measures were investigated to determine their association with executive performance.

Results.

DSRELs showed more executive dysfunction on WCST and poorer social functioning than CCs and more severe negative symptoms than non-DSRELs. Differences on WCST-categories achieved (WCST-CA) remained significant after adjustment for clinical confounders and IQ. WCST-CA was associated with apathy and paranoid ideation only within the DSREL subgroup.

Conclusions.

Executive functioning and negative symptoms are severely impaired in first-degree relatives of deficit syndrome patients, thus suggesting that some neurocognitive deficits in patients may be transmitted within families according to the pathophysiology of the probands.

Keywords

executive functionnegative symptomsrelativesschizophrenia
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 23 , Issue 1 , March 2014 , pp. 85 - 97
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). American Psychiatric Association, Washington, DC.Google Scholar
Agnew-Blais, J, Seidman, LJ (2012). Neurocognition in youth and young adults under age 30 at familial risk for schizophrenia: a quantitative and qualitative review. Cognitive Neuropsychiatry, 1–39.Google Scholar
Amaddeo, F, Beecham, J, Bonizzato, P, Fenyo, A, Knapp, M, Tansella, M (1997). The use of a case register to evaluate the costs of psychiatric care. Acta Psychiatrica Scandinavica 95, 189–198.Google Scholar
Amador, XF, Kirkpatrick, B, Buchanan, RW, Carpenter, WT, Marcinko, L, Yale, SA (1999). Stability of the diagnosis of deficit syndrome in schizophrenia. American Journal of Psychiatry 156, 637–639.Google Scholar
Andreasen, NC (1983). The Scale of the Assessment of Negative Symptoms (SANS). University of Iowa: Iowa City.Google Scholar
Andreasen, NC, Olsen, SA (1982). Negative vs. Positive schizophrenia: definition and validation. Archives of General Psychiatry 39, 789–794.Google Scholar
Barch, DM, Dowd, EC (2010). Goal representations and motivational drive in schizophrenia: the role of prefrontal–striatal interactions. Schizophrenia Bulletin 36, 919–934.Google Scholar
Barrantes-Vidal, N, Aguilera, M, Campanera, S, Fatjó-Vilas, M, Guitart, M, Miret, S, Valero, S, Fañanás, L (2007). Working memory in siblings of schizophrenia patients. Schizophrenia Research 95, 70–75.CrossRefGoogle ScholarPubMed
Bates, JA, Malhotra, AK (2002). Genetic factors and neurocognitive traits. CNS Spectrums 7, 274–280, 283–284.Google Scholar
Bellani, M, Perlini, C, Brambilla, P (2009). Language disturbances in schizophrenia. Epidemiology and Psychiatric Sciences 18, 314–317.Google Scholar
Benoit, A, Bodnar, M, Malla, AK, Joober, R, Lepage, M (2012). The structural neural substrates of persistent negative symptoms in first-episode of non-affective psychosis: a voxel-based morphometry study. Frontiers in Psychiatry 3, 42.Google Scholar
Brooker, BH, Cyr, JJ (1986). Tables for clinicians to use to convert WAIS-R short forms. Journal of Clinical Psychology 42, 982–986.Google Scholar
Bryson, G, Whelahan, HA, Bell, M (2001). Memory and executive function impairments in deficit syndrome schizophrenia. Psychiatry Research 102, 29–37.CrossRefGoogle ScholarPubMed
Buchanan, RW, Kirkpatrick, B, Heinrichs, DW, Carpenter, WT Jr (1990). Clinical correlates of the deficit syndrome of schizophrenia. American Journal of Psychiatry 147, 290–294.Google Scholar
Buchanan, RW, Strauss, ME, Kirkpatrick, B, Holstein, C, Breier, A, Carpenter, WT Jr (1994). Neuropsychological impairments in deficit vs. nondeficit forms of schizophrenia. Archives of General Psychiatry 51, 804–811.CrossRefGoogle ScholarPubMed
Buchanan, RW, Strauss, ME, Breier, A, Kirkpatrick, B, Carpenter, WT Jr. (1997). Attentional impairments in deficit and nondeficit forms of schizophrenia. American Journal of Psychiatry 154, 363–370.Google Scholar
Byrne, M, Hodges, A, Grant, E, Owens, DC, Johnstone, EC (1999). Neuropsychological assessment of young people at high genetic risk for developing schizophrenia compared with controls: preliminary findings of the Edinburgh High Risk Study (EHRS). Psychological Medicine 29, 1161–1173.Google Scholar
Cannon, TD, Glahn, DC, Kim, J, Van Erp, TG, Karlsgodt, K, Cohen, MS, Nuechterlein, KH, Bava, S, Shirinyan, D (2005). Dorsolateral prefrontal cortex activity during maintenance and manipulation of information in working memory in patients with schizophrenia. Archives of General Psychiatry 62, 1071–1080.Google Scholar
Carpenter, WT Jr., Kirkpatrick, B (1988). The heterogeneity of the long-term course of schizophrenia. Schizophrenia Bulletin 14, 645–652.Google Scholar
Carpenter, WT, Heirrichs, DW, Wagner, AMI (1988). Deficit and nondeficit forms of schizophrenia: the concept. American Journal of Psychiatry 145, 578–583.Google Scholar
Cascella, NG, Fieldstone, SC, Rao, VA, Pearlson, GD, Sawa, A, Schretlen, DJ (2010). Gray-matter abnormalities in deficit schizophrenia. Schizophrenia Research 120, 63–70.Google Scholar
Castle, DJ, Sham, PC, Wessely, S, Murray, RM (1994). The subtyping of schizophrenia in men and women: a latent class analysis. Psychological Medicine 24, 41–51.Google Scholar
Cohen, AS, Brown, LA, Minor, KS (2010). The psychiatric symptomatology of deficit schizophrenia: a meta-analysis. Schizophrenia Research 118, 122–7.Google Scholar
Cohen, AS, Saperstein, AM, Gold, JM, Kirkpatrick, B, Carpenter, WT Jr., Buchanan, RW (2007). Neuropsychology of the deficit syndrome: new data and meta-analysis of findings to date. Schizophrenia Bulletin 33, 1201–1212.CrossRefGoogle ScholarPubMed
Cohen, J (1988). Statistical Power Analysis for the Behavioral Sciences, 2nd ed.Lawrence Earlbaum Associates, Hillsdale, NJ.Google Scholar
Compton, RJ, Banich, MT, Mohanty, A, Milham, MP, Herrington, J, Miller, GA, Scalf, PE, Webb, A, Heller, W (2003). Paying attention to emotion: an fMRI investigation of cognitive and emotional Stroop tasks. Cognitive, Affective and Behavioral Neurosciece 3, 81–96.CrossRefGoogle ScholarPubMed
Conklin, HM, Curtis, CE, Calkins, ME, Iacono, WG (2005). Working memory functioning in schizophrenia patients and their first-degree relatives: cognitive functioning shedding light on etiology. Neuropsychologia 43, 930–942.Google Scholar
Crow, TJ (1985). The two-syndrome concept: origins and current status. Schizophrenia Bulletin 11, 471–786.Google Scholar
Cuesta, MJ, Peralta, V, Caro, F, de Leon, J (1995). Schizophrenic syndrome and Wisconsin Card Sorting Test dimensions. Psychiatry Research 58, 45–51.Google Scholar
Delamillieure, P, Fernandez, J, Constans, JM, Brazo, P, Benali, K, Abadie, P, Vasse, T, Thibaut, F, Courtheoux, P, Petit, M, Dollfus, S (2000). Proton magnetic resonance spectroscopy of the medial prefrontal cortex in patients with deficit schizophrenia: preliminary report. American Journal of Psychiatry 157, 641–643.Google Scholar
Delamillieure, P, Constans, JM, Fernandez, J, Brazo, P, Dollfus, S (2004). Relationship between performance on the Stroop test and N-acetylaspartate in the medial prefrontal cortex in deficit and nondeficit schizophrenia: preliminary results. Psychiatry Research: Neuroimaging 132, 87–89.Google Scholar
Derogatis, LR (1993). Symptom Checklist-90-R (SCL-90). Computer Systems: Minneapolis.Google Scholar
Dollfus, S, Ribeyre, JM, Petit, M (1996). Family history and deficit form in schizophrenia. European Psychiatry 11, 260–262.Google Scholar
Dollfus, S, Germain-Robin, S, Chabot, B, Brazo, P, Delamillieure, P, Langlois, S, van der Eist, A, Campion, D, Petit, M (1998). Family history and obstetric complications in deficit and non-deficit schizophrenia: preliminary results. European Psychiatry 13, 270–272.Google Scholar
Dominguez, MG, Viechtbauer, W, Simons, CJ, van Os, J, Krabbendam, L (2009). Are psychotic psychopathology and neurocognition orthogonal? A systematic review of their associations. Psychological Bulletin 135, 157–171.Google Scholar
Erol, A, Bayram, S, Kosger, F, Mete, L (2012). Executive functions in patients with familial versus sporadic schizophrenia and their parents. Neuropsychobiology 17, 93–99.Google Scholar
Faraone, SV, Seidman, LJ, Kremen, WS, Pepple, JR, Lyons, MJ, Tsuang, MT (1995). Neuropsychological functioning among the nonpsychotic relatives of schizophrenic patients: a diagnostic efficiency analysis. Journal of Abnormal Psychology 104, 286–304.Google Scholar
Faraone, SV, Seidman, LJ, Kremen, WS, Toomey, R, Lyons, MJ, Tsuang, MT (1996). Neuropsychological functioning among the elderly nonpsychotic relatives of schizophrenic patients. Schizophrenia Research 20, 27–31.Google Scholar
Fenton, WS, McGlashan, TH (1994). Antecedents, symptom progression, and long-term outcome of the deficit syndrome in schizophrenia. American Journal of Psychiatry 151, 351–356.Google ScholarPubMed
Goetz, RR, Corcoran, C, Yale, S, Stanford, AD, Kimhy, D, Amador, X, Malaspina, D (2007). Validity of a 'proxy' for the deficit syndrome derived from the positive and negative syndrome scale (PANSS). Schizophrenia Research 93, 169–177.Google Scholar
Goghari, VM (2011). Executive functioning related brain abnormalities associated with the genetic liability for schizophrenia: an activation likelihood estimation meta-analysis. Psychological Medicine 41, 1239–1252.Google Scholar
Gonul, AS, Kula, M, Esel, E, Tutus, A, Sofuoglu, S (2003). A Tc-99 m HMPAO SPECT study of regional cerebral blood flow in drug-free schizophrenic patients with deficit and non-deficit syndrome. Psychiatry Research: Neuroimaging 123, 199–205.Google Scholar
Gur, RE, Nimgaonkar, VL, Almasy, L, Calkins, ME, Ragland, JD, Pogue-Geile, MF, Kanes, S, Blangero, J, Gur, RC (2007). Neurocognitive endophenotypes in a multiplex multigenerational family study of schizophrenia. American Journal of Psychiatry 164, 813–819.Google Scholar
Heaton, RK (1981). Wisconsin Card Sorting Test. Psychological Assessment Resources: Odessa.Google Scholar
Heckers, S, Goff, D, Schacter, DL, Savage, CR, Fischman, AJ, Alpert, NM, Rauch, SL (1999). Functional imaging of memory retrieval in deficit vs. nondeficit schizophrenia. Archives of General Psychiatry 56, 1117–1123.Google Scholar
Kay, SR, Fiszbein, A, Opler, LA (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261–76.Google Scholar
Kimhy, D, Yale, S, Goetz, RR, Marcinko McFarr, L, Malaspina, D (2006). The factorial structure of the schedule for the deficit syndrome in schizophrenia. Schizophrenia Bulletin 32, 274–278.Google Scholar
Kirkpatrick, B, Galderisi, S (2008). Deficit schizophrenia: an update. World Psychiatry 7, 143–147.Google Scholar
Kirkpatrick, B, Buchanan, RW, McKenney, PD, Alphs, LD, Carpenter, WT Jr. (1989). The schedule for the deficit syndrome: an instrument for research in schizophrenia. Psychiatry Research 30, 119–123.Google Scholar
Kirkpatrick, B, Buchanan, RW, Breier, A, Carpenter, WT Jr. (1993). Case identification and stability of the deficit syndrome of schizophrenia. Psychiatry Research 47, 47–56.Google Scholar
Kirkpatrick, B, Ross, DE, Walsh, D, Karkowski, L, Kendler, KS (2000). Family characteristics of deficit and nondeficit schizophrenia in the Roscommon family study. Schizophrenia Research 45, 57–64.Google Scholar
Kravariti, E, Russo, M, Vassos, E, Morgan, K, Fearon, P, Zanelli, JW, Demjaha, A, Lappin, JM, Tsakanikos, E, Dazzan, P, Morgan, C, Doody, GA, Harrison, G, Jones, PB, Murray, RM, Reichenberg, A (2012). Linear and non-linear associations of symptom dimensions and cognitive function in first-onset psychosis. Schizophrenia Research 140, 221–231.Google Scholar
Lahti, AC, Holcomb, HH, Medoff, DR, Weiler, MA, Tamminga, CA, Carpenter, WT Jr. (2001). Abnormal patterns of regional cerebral blood flow in schizophrenia with primary negative symptoms during an effortful auditory recognition task. American Journal of Psychiatry 158, 1797–1808.Google Scholar
Lin, A, Nelson, B, Yung, AR (2012). 'At-risk' for psychosis research: where are we heading? Epidemiology and Psychiatric Sciences 30, 1–6.Google Scholar
Milham, MP, Banich, MT, Barad, V (2003). Competition for priority in processing increases prefrontal cortex's involvement in top-down control: an event-related fMRI study of the Stroop task. Cognitive Brain Research 17, 212–222.Google Scholar
Milner, B (1975). Psychological aspects of focal epilepsy and its neurosurgical management. Advances in Neurology 8, 299–321.Google Scholar
Nakaya, M, Ohmori, K (2008). A two-factor structure for the Deficit Syndrome in schizophrenia. Psychiatry Research 158, 256–259.Google Scholar
Nuechterlein, KH, Barch, DM, Gold, JM, Goldberg, TE, Green, MF, Heaton, RK (2004). Identification of separable cognitive factors in schizophrenia. Schizophrenia Research 72, 29–39.Google Scholar
Ochsner, KN, Gross, JJ (2005). The cognitive control of emotion. Trends in Cognitive Sciences 9, 242–249.Google Scholar
Pogue-Geile, MF, Harrow, M (1985). Negative symptoms in schizophrenia: their longitudinal course and prognostic importance. Schizophrenia Bulletin 11, 427–439.Google Scholar
Polgár, P, Réthelyi, JM, Bálint, S, Komlósi, S, Czobor, P, Bitter, I (2010). Executive function in deficit schizophrenia: what do the dimensions of the Wisconsin Card Sorting Test tell us? Schizophrenia Research 122, 85–93.Google Scholar
Réthelyi, JM, Czobor, P, Polgár, P, Mersich, B, Bálint, S, Jekkel, E, Magyar, K, Mészáros, A, Fábián, A, Bitter, I (2012). General and domain-specific neurocognitive impairments in deficit and non-deficit schizophrenia. European Archives of Psychiatry and Clinical Neuroscience 262, 107–115.Google Scholar
Ross, DE, Kirkpatrick, B, Karkowski, LM, Straub, RE, MacLean, CJ, O'Neill, FA, Compton, AD, Murphy, B, Walsh, D, Kendler, KS (2000). Sibling correlation of deficit syndrome in the Irish study of high-density schizophrenia families. American Journal of Psychiatry 157, 1071–1076.Google Scholar
Ross, E, Orbelo, D, Cartwright, J, Hansel, S, Burgard, M, Testa, J, Buck, R (2001). Affective-prosodic deficits in schizophrenia: profiles of patients with brain damage and comparison with relation to schizophrenic symptoms. Journal of Neurology, Neurosurgery and Psychiatry 70, 597–604.Google Scholar
Rosso, IM, Makris, N, Thermenos, HW, Hodge, SM, Brown, A, Kennedy, D, Caviness, VS, Faraone, SV, Tsuang, MT, Seidman, LJ (2010). Regional prefrontal cortex gray matter volumes in youth at familial risk for schizophrenia from the Harvard Adolescent High Risk Study. Schizophrenia Research 123, 15–21.Google Scholar
Scala, S, Lasalvia, A, Cristofalo, D, Bonetto, C, Ruggeri, M (2012). Neurocognitive profile and its association with psychopathology in first-degree relatives of patients with schizophrenia. A case-control study. Psychiatry Research 200, 137–143.CrossRefGoogle ScholarPubMed
Seidman, LJ, Thermenos, HW, Poldrack, RA, Peace, NK, Koch, JK, Faraone, SV, Tsuang, MT (2006). Altered brain activation in dorsolateral prefrontal cortex in adolescents and young adults at genetic risk for schizophrenia: An fMRI study of working memory. Schizophrenia Research 85, 58–72.Google Scholar
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59, 22–33.Google Scholar
Skelley, SL, Goldberg, TE, Egan, MF, Weinberger, DR, Gold, JM (2008). Verbal and visual memory: characterizing the clinical and intermediate phenotype in schizophrenia. Schizophrenia Research 105, 78–85.Google Scholar
Snitz, BE, Macdonald, AW, Carter, CS (2006). Cognitive deficits in unaffected first-degree relatives of schizophrenia patients: a meta-analytic review of putative endophenotypes. Schizophrenia Bulletin 32, 179–194.Google Scholar
Spitzer, R, Williams, JBV, Gibbon, M, First, MB (1990). Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). American Psychiatric Press, Washington, DC. (Italian Version: Fava M, Guaraldi GB, Mazzi F, Rigatelli M, 1993).Google Scholar
Stolar, N, Berenbaum, H, Banich, MT, Barch, D (1994). Neuropsychological correlates of alogia and affective flattening in schizophrenia. Biological Psychiatry 35, 164–172.Google Scholar
Strauss, GP, Harrow, M, Grossman, LS, Rosen, C (2010). Periods of recovery in deficit syndrome schizophrenia: a 20-year multi-follow-up longitudinal study. Schizophrenia Bulletin 36, 788–799.Google Scholar
Szoke, A, Schurhoff, F, Mathieu, F, Meary, A, Ionescu, S, Leboyer, M (2005). Tests of executive functions in first-degree relatives of schizophrenic patients: a meta-analysis. Psychological Medicine 35, 771–782.Google Scholar
Tallent, KA, Gooding, DC (1999). Working memory and Wisconsin Card Sorting Test performance in schizotypic individuals: a replication and extension. Psychiatry Research 89, 161–170.Google Scholar
Tamminga, CA, Thaker, OK, Buchanan, R, Kirkpatrick, B, Alphs, LD, Chase, TN, Carpenter, WT (1992). Limbic system abnormalities identified in schizophrenia using positron emission tomography with fluorodeoxyglucose and neocortical alterations with deficit syndrome. Archives of General Psychiatry 49, 522–530.Google Scholar
Tansella, M, Amaddeo, F, Burti, L, Lasalvia, A, Ruggeri, M (2006). Evaluating a community-based mental health service focusing on severe mental illness. The Verona experience. Acta Psychiatrica Scandinavica 429, 90–94.Google Scholar
Taylor, SF, Welsh, RC, Wager, TD, Phan, KL, Fitzgerald, KD, Gehring, WJ (2004). Functional neuroimaging study of motivation and executive function. Neuroimage 21, 1045–1054.Google Scholar
Tek, C, Kirkpatrick, B, Buchanan, RW (2001). A five-year follow-up study of deficit and nondeficit schizophrenia. Schizophrenia Research 49, 253–260.Google Scholar
Thabane, L, Ma, J, Chu, R, Cheng, J, Ismaila, A, Rios, LP, Robson, R, Thabane, M, Giangregorio, L, Goldsmith, CH (2010). A tutorial on pilot studies: the what, why and how. BMC Medical Research Methodology 10, 1.Google Scholar
Turetsky, B, Cowell, PE, Gur, RC, Grossman, RI, Shtasel, DL, Gur, RE (1995). Frontal and temporal lobe brain volumes in schizophrenia. Relationship to symptoms and clinical subtype. Volumetric measure of the frontal and temporal lobe regions in schizophrenia: relationship to negative symptoms. Archives of General Psychiatry 52, 1061–1070.Google Scholar
Vollema, MG, Postma, B (2002). Neurocognitive correlates of schizotypy in first degree relatives of schizophrenia patients. Schizophrenia Bulletin 28, 367–377.Google Scholar
Wang, XS, Yao, S, Kirkpatrick, B, Shi, C, Yi, J (2008). Psychopathology and neuropsychological impairments in deficit and nondeficit schizophrenia of Chinese origin. Psychiatry Research 158, 195–205.Google Scholar
World Health Organization (1988). Disability Assessment Schedule-II (DAS). World Health Organization: Geneva.Google Scholar