Defining cognitive and functional profiles in schizophrenia and affective disorders

Abstract

Background: Neurocognitive 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.

Method: In 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.

Results: The 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.

Conclusion: Considering 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.

Keywords: Daily skill functioning; Depression; Mania; Neurocognitive tests; Schizophrenia.

Fig. 1

The six domains of the Brief Assessment of Cognition in Schizophrenia (BACS) across patients with schizophrenia (SZ), patients with major depressive disorder (MDD), patients with bipolar I disorders (BD), and healthy control subjects (HC). *p < 0.05, **p < 0.01, ***p < 0.001

Fig. 2

The three domains of the UCSD Performance-based Skills Assessment, Brief Version (UPSA-B) across patients with schizophrenia (SZ), patients with major depressive disorder (MDD), patients with bipolar I disorders (BD), and healthy control subjects (HC). *p < 0.05, **p < 0.01, ***p < 0.001