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. 2002 Sep;24(6):765-80.
doi: 10.1076/jcen.24.6.765.8402.

Neuropsychological profiles delineate distinct profiles of schizophrenia, an interaction between memory and executive function, and uneven distribution of clinical subtypes

S Kristian Hill  1 , J Daniel Ragland, Ruben C Gur, Raquel E Gur
Affiliations

Neuropsychological profiles delineate distinct profiles of schizophrenia, an interaction between memory and executive function, and uneven distribution of clinical subtypes

S Kristian Hill et al. J Clin Exp Neuropsychol. 2002 Sep.

Abstract

Neuropsychological performance in 151 patients with schizophrenia was examined using cluster analysis to identify neurocognitive subtypes. Hierarchical and iterative partitioning methods identified four clusters using an extended neuropsychological battery. Consistent with previous findings two extreme clusters were characterized by near normative performance and profound global dysfunction, respectively. The two remaining neurocognitive clusters displayed moderate-severe dysfunction and were differentiated by unique patterns of abstraction and flexibility, attention, spatial memory, and sensory-perception. Analysis of variance revealed an interaction between global memory and executive function for clusters III and IV. Although limited cluster differences were found relative to clinical and historical data, the distribution of previously defined clinical subtypes was uneven among neurocognitive clusters. Paranoid patients were significantly more likely to be classified into cluster II and disproportionately absent from clusters I and IV. Patients with negative and disorganized clinical subtypes comprised a disproportionate component of clusters I and IV but were less likely to be classified in cluster II. This suggests greater correspondence than previously postulated between systems responsible for clinical symptomatology and those moderating neurocognitive dysfunction.

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Figures

Fig. 1
Fig. 1
Mean neuropsychological profiles (± SEM) of the four neurocognitive clusters. Neuropsychological functions are abstraction (ABF), attention (ATT), verbal memory (VMEM), visual-spatial memory (SMEM), language (LAN), spatial abilities (SPA), sensory-perception (SEN), and motor skills (MOT). Cluster I: Severe and Profound Global Dysfunction; Cluster II: Near Normative Performance with Mild Dysfunction in Verbal Memory; Cluster III: Moderate-severe with more Prominent Executive than Memory Dysfunction; Cluster IV: Moderate-severe with more Prominent Memory than Executive Dysfunction.
Fig. 2
Fig. 2
Cluster means (± SEM) for estimated intellectual skills (combined WAIS–R Vocabulary and Block Design). Cluster II (near normative performance) displayed significantly higher intelligence scores than any other cluster. On the other hand, cluster I (diffuse and profound dysfunction) had lower intelligence scores than clusters II or III.
Fig. 3(a)–(d)
Fig. 3(a)–(d)
Comparison between observed and expected distribution of clinical subtypes by neurocognitive cluster. *χ2 significant (p < .05).
Fig. 3(a)–(d)
Fig. 3(a)–(d)
Comparison between observed and expected distribution of clinical subtypes by neurocognitive cluster. *χ2 significant (p < .05).
See this image and copyright information in PMC

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