Abstract
Background: Cognitive dysfunction is considered a core feature among schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MDD). Despite abundant literature comparing cognitive dysfunction among these disorders, the relationship between cognitive dysfunction and symptom dimensions remains unclear. The study aims are a) to identify the factor structure of the BPRS-18 and b) to examine the relationship between symptom domains and cognitive function across SZ, BD, and MDD. Methods: A total of 716 participants [262 with SZ, 104 with BD, 101 with MDD, and 249 healthy controls (HC)] were included in the study. One hundred eighty participants (59 with SZ, 23 with BD, 24 with MDD, and 74 HC) completed the MATRICS Consensus Cognitive Battery (MCCB), and 507 participants (85 with SZ, 89 with BD, 90 with MDD, and 243 HC) completed the Wisconsin Card Sorting Test (WCST). All patients completed the Brief Psychiatric Rating Scale (BPRS). Results: We identified five BPRS exploratory factor analysis (EFA) factors (“affective symptoms,” “psychosis,” “negative/disorganized symptoms,” “activation,” and “noncooperation”) and found cognitive dysfunction in all of the participant groups with psychiatric disorders. Negative/disorganized symptoms were the most strongly associated with cognitive dysfunctions across SZ, BD, and MDD. Conclusions: Our findings suggest that cognitive dysfunction severity relates to the negative/disorganized symptom domain across SZ, BD, and MDD, and negative/disorganized symptoms may be an important target for effective cognitive remediation in SZ, BD, and MDD.
Highlights
Schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MDD) have long been viewed as distinct disorders based on differing clinical presentations [1]; there is substantial evidence suggesting that these disorders share pathophysiological and clinical manifestations [2, 3]
Post hoc analysis revealed that the BD and MDD groups significantly differed from the SZ group in Brief Psychiatric Rating Scale (BPRS) total score and Exploratory factor analysis (EFA) factor scores of “affective symptoms,” “psychosis,” “negative/disorganized symptoms,” and “noncooperation.” There were no significant differences between BD and MDD groups
We identified the factor structure of the BPRS-18 in SZ, BD, and MDD and examined the relationship between BPRS EFA factors and cognitive function across the three disorders
Summary
Schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MDD) have long been viewed as distinct disorders based on differing clinical presentations [1]; there is substantial evidence suggesting that these disorders share pathophysiological and clinical manifestations [2, 3]. Studies have noted similar cognitive patterns and profiles in SZ, BD, and MDD [14,15,16] To further investigate this theory, cognitive function appears to be a relatively stable intermediate phenotype that may provide insight into the potential link between SZ, BD, and MDD [17, 18]. This is further supported by extensive literature implicating a continuum of cognitive dysfunction severity based on severity of neuropsychiatric illness [15, 19, 20]. The study aims are a) to identify the factor structure of the BPRS-18 and b) to examine the relationship between symptom domains and cognitive function across SZ, BD, and MDD
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