Can self-experienced neuropsychological deficits indicate propensity to schizophrenic psychosis? Results of an 8-year prospective follow-up study

Abstract

We investigated the potential predictive value of early self-experienced neuropsychological deficits for the subsequent development of schizophrenia. We re-examined 96 patients diagnosed, according to the third revised Diagnostic and statistical manual of mental disorders (DSM-III-R), with personality disorder or what were formerly called neurotic disorders, who had been examined for the presence of subjective experiences of deficits with the Bonn Scale for the Assessment of Basic Symptoms (BSABS), in order to determine whether they had undergone a transition to a schizophrenic disorder. Of these 96 patients, 78 (81%) had displayed basic symptoms at the initial assessment. After an average follow-up period of about 8 years, more than half of the patients (58%) had developed schizophrenia according to DSM-III-R criteria or defined by the presence of at least one component of the ninth version of the Present State Examination (PSE9) nuclear syndrome. In 77% the outcome, transition or absence of transition to schizophrenia was correctly predicted by the earlier presence or absence of self-experienced disturbances of thought, speech, memory, perception and action. Development of a schizophrenic psychosis was predicted with a specificity of 45% and a sensitivity of 100%. These findings suggest that certain self-experienced neuropsychological deficits are able to indicate a propensity to a schizophrenic psychosis.