Jacek Wciórka, Anna Bembenek, Beata Hintze, Aleksandra Kühn-Dymecka

Schizophrenic disorders - do cognitive dysfunctions relate to course characteristics

and the psychopathological picture?             5-17

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SUMMARY

Aim: Cognitive dysfunctions are nowadays often considered as fundamental characteristics of schizophrenic disorders essential for pathogenesis and clinical aspects of the disease as well as social functioning of the patients. The aim of the study was to determine the associations between some chosen indicators of disordered cognitive functions and some chosen variables describing the course and the clinical picture of schizophrenic disorders.

Material and method: 69 patients satisfying both DSM-IV and ICD-10 schizophrenia criteria were examined. Two clinical tools were used for the assessment of the clinical state (scales: PANSS and KOSS), and similarly two scales for the assessment of premorbid functioning (scales: GAF and W). Neurocognitive dysfunctions were examined with the help of computer-aided tests from the Vienna Test System including the measures of: reaction time (RT), visual line pursuit (LVT), perseveration (PERSEV), and the capacity of visuospatial memory (CORSI). Simple non-parametric tests and rank correlation coefficients were used in statistical analysis.

Results: The associations between cognitive dysfunctions and: age, social functioning before hospitalisation, duration of the disease and the number of hospitalisations were discovered. The dysfunctions were less pronounced at the time of the first episode than in the relapse phase or the residual phase. The quantitative assessment of disorders' severity did not correlate with cognitive dysfunctions, but the detailed analysis of the psychopathological picture revealed correlations between some dysfunctions with the dimensions of deficit, disorganisation and dysphoria. The distortion dimension (positive) did not reveal such  associations. All the indicators of cognitive dysfunctions correlated with worse results of the current episode treatment. All the significant correlations reached only a weak or moderate level.

Conclusions: Cognitive dysfunctions are associated with rather unfavourable characteristics of the disease course. The results of the psychopathological assessment correlate weakly with the neuropsychological assessment - cognitive dysfunctions are associated with deficit, disorganisation and dysphoria rather than productive symptoms of the disease in question.