Impairment of neurocognitive and performance-based skills in deficit and non-deficit patients with drug-naïve first-episode schizophrenia

Abstract

Objective To evaluate impairment of neurocognitive and performance-based skills in deficit and non-deficit patients with drug-naive first-episode schizophrenia. Methods Eighty-three schizophrenic patients meeting Diagnostic and Statistical Manual fourth edition (DSM-Ⅳ) and 50 healthy controls subjects matched for sex, education were recruited. Patients were categorized into deficit, non-deficit subtypes with the Schedule for Deficit Syndrome (SDS). They were assessed with the Measurement and Treatment Research to Improve Cognition In Schizophrenia (MATRICS) consensus cognitive battery (MCCB), Stroop, digit span test, emotional recognition test, University of Califonia San Diego performance-based skill assessment (UPSA) and Positive and negative syndrome scale (PANSS) (except for healthy controls). Results Compared to the non-deficit subtypes, age of onset of illness was significantly earlier in deficit subtypes (24.6±8.4 vs. 29.4±10.0, t=-2.31, P=0.02). The PANSS total score, the negative subscore and the general psychopathology subscore of PANSS were markedly higher in deficit subtypes than that in non-deficit subtypes. Deficit subtypes had significantly lower on symbol coding, digit sequencing, MCCB total score compared to the non-deficit subtypes. Deficit subtypes were poorer on total UPSA score and communication skill subscore compared to the non-deficit subtypes. Conclusions The deficit subtypes have the worst cognitive dysfunctions and the lowest performance-based skills in comparison with non-deficit patients with first-episode schizophrenia and the healthy subjects. Key words: Schizophrenia; Neurobehavioral manifestations; Psychometrics; Deficit syndrome; Living skill