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J Affect Disord. 2016 Mar 1;192:109-15. doi: 10.1016/j.jad.2015.12.022. Epub 2015 Dec 17.

Does cognitive performance map to categorical diagnoses of schizophrenia, schizoaffective disorder and bipolar disorder? A discriminant functions analysis.

Author information

1
Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia; Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia. Electronic address: tamsyn.van@unimelb.edu.au.
2
Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; School of Psychological Sciences, Monash University, Melbourne, Australia.
3
Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia.
4
Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia.
5
Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia.

Abstract

OBJECTIVES:

Despite known overlaps in the pattern of cognitive impairments in individuals with bipolar disorder (BD), schizophrenia (SZ) and schizoaffective disorder (SZA), few studies have examined the extent to which cognitive performance validates traditional diagnostic boundaries in these groups.

METHOD:

Individuals with SZ (n=49), schizoaffective disorder (n=33) and BD (n=35) completed a battery of cognitive tests measuring the domains of processing speed, immediate memory, semantic memory, learning, working memory, executive function and sustained attention.

RESULTS:

A discriminant functions analysis revealed a significant function comprising semantic memory, immediate memory and processing speed that maximally separated patients with SZ from those with BD. Initial classification scores on the basis of this function showed modest diagnostic accuracy, owing in part to the misclassification of SZA patients as having SZ. When SZA patients were removed from the model, a second cross-validated classifier yielded slightly improved diagnostic accuracy and a single function solution, of which semantic memory loaded most heavily.

CONCLUSIONS:

A cluster of non-executive cognitive processes appears to have some validity in mapping onto traditional nosological boundaries. However, since semantic memory performance was the primary driver of the discrimination between BD and SZ, it is possible that performance differences between the disorders in this cognitive domain in particular, index separate underlying aetiologies.

KEYWORDS:

Discriminant functions analysis; Executive function; Mood; Neurocognition; Neuropsychology; Psychosis; Stroop; Working memory

PMID:
26720009
DOI:
10.1016/j.jad.2015.12.022
[Indexed for MEDLINE]

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