Abstract
BackgroundNeurocognitive dysfunction is a common symptom of various major psychiatric disorders, including schizophrenia, major depressive disorder (MDD), and bipolar I disorder (BD). In this study, we investigated whether cognitive profiles and daily skill functioning could effectively differentiate between patients with schizophrenia, MDD, and BD.MethodIn this cross-sectional study, we recruited a total of 63 patients with schizophrenia, 55 patients with MDD, 43 patients with BD, and 92 healthy control subjects. We evaluated participants’ cognitive functions and functional capacity using the Brief Assessment of Cognition in Schizophrenia (BACS) and the UCSD Performance-based Skills Assessment, Brief Version (UPSA-B), respectively. Multivariate analysis of covariance was then adopted to determine inter-group differences in BACS and UPSA-B performance.ResultsThe BACS was capable of differentiating patients with a major psychiatric disorder (schizophrenia, MDD, and BD) from healthy subjects. Furthermore, schizophrenia patients had poorer motor speed performance than patients with affective disorders. The UPSA-B, particularly the financial portion, was able to distinguish schizophrenia patients from other groups. However, we did not observe any differences in UPSA-B performance between patients with mood disorders and the healthy controls. No significant difference between patients with BD and those with MDD were observed in either cognitive function or in functional capacity. The performances of the BACS and the UPSA-B were positively correlated, particularly in the MDD group.ConclusionConsidering overall performance, the BACS and the UPSA-B characterize different endophenotyping profiles in the aforementioned four participant groups. Therefore, the results support the need for comprehensive assessments that target both cognitive function and functional capacity for patients with major psychiatric disorders.
Highlights
Neurocognitive dysfunction is a common symptom of various major psychiatric disorders, including schizophrenia, major depressive disorder (MDD), and bipolar I disorder (BD)
The Brief Assessment of Cognition in Schizophrenia (BACS) was capable of differentiating patients with a major psychiatric disorder from healthy subjects
No significant difference between patients with BD and those with MDD were observed in either cognitive function or in functional capacity
Summary
Neurocognitive dysfunction is a common symptom of various major psychiatric disorders, including schizophrenia, major depressive disorder (MDD), and bipolar I disorder (BD). We investigated whether cognitive profiles and daily skill functioning could effectively differentiate between patients with schizophrenia, MDD, and BD. Patients with schizophrenia may have cognitive impairments in such domains as attention, motor and processing speed, verbal and spatial memory, working memory, and executive function [4, 5]. The selected cognition battery subtests were the six cognitive function domains that are considerably impaired in schizophrenia (i.e., verbal memory, motor speed, working memory, verbal learning, attention, and executive function) [17] and significantly associated with real-world functional outcomes in schizophrenia patients [18, 19]. Another study [23] suggested that BD and schizophrenia presented with similar impairments in neurocognitive functioning, while MDD patients expressed fewer neurocognitive impairments compared to either BD or schizophrenia. Chen et al [24] indicated that more severe deficits in certain cognitive domains were found in patients with schizophrenia compared to those with BD
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