Correlation of Lifetime Symptom Dimensions with Cognitive Function and Other Clinical Characteristics in Schizophrenia Patients

Youngah Cho; Seunghyong Ryu; Hyeji Oh; Sohee Oh; Taesung Park; Se Chang Yoon; Kyung Sue Hong

doi:10.16946/kjsr.2014.17.2.72

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Cho, Ryu, Oh, Oh, Park, Yoon, and Hong: Correlation of Lifetime Symptom Dimensions with Cognitive Function and Other Clinical Characteristics in Schizophrenia Patients

Original Article

Korean J Schizophr Res 2014;17(2):72-79.

Published online: 20 January 2014

DOI: https://doi.org/10.16946/kjsr.2014.17.2.72

Correlation of Lifetime Symptom Dimensions with Cognitive Function and Other Clinical Characteristics in Schizophrenia Patients

Youngah Cho, MD¹, Seunghyong Ryu, MD¹, Hyeji Oh, MA², Sohee Oh, PhD³, Taesung Park, PhD, Se Chang Yoon, MD, PhD¹, Kyung Sue Hong, MD, PhD^1,^2,

¹Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

²Center for Clinical Research, Samsung Biomedical Research Institute, Seoul, Korea

³Department of Biostatistics, Boramae Medical Center, Seoul,⁴Department of Statistics, Seoul National University, Seoul, Korea

Address for correspondence: Kyung Sue Hong, Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ir-won-ro, Gangnam-gu, Seoul 135-710, Korea Tel: 02-3410-3584, Fax: 02-3410-0050, E-mail: hongks@skku.edu

Received 31 July 2014 Revised 24 September 2014 Accepted 26 September 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

Considering large diversity of clinical presentation of schizophrenia, it is important to identify valid clinical subtypes or dimensions that might have homogeneous biological underpinning. The current study aimed to explore lifetime symptom-based dimensional phenotypes in patients with chronic schizophrenia, and to investigate their correlation with cognitive functions and other clinical characteristics.

Methods

Lifetime-based symptoms and additional clinical variables were measured using the Diagnostic Interview for Genetic Studies and the Schedule for the Deficit Syndrome in 315 clinically stable patients with chronic schizophrenia. Through principal components factor analysis, eight dimensional phenotypes were obtained. Comprehensive neuropsychological tests were administered for 103 out of 315 patients, and domain scores were calculated for cognitive domains defined in the MATRICS consensus battery.

Results

: ‘Non-paranoid delusion factor' including delusions of grandiose or religious nature, showed significant negative correlation with processing speed, working memory, attention/vigilance, and general cognitive ability, and positive correlation with intraindividual variability. ‘Negative symptom factor' showed significant negative correlation only with general cognitive ability. Those two factors were also negatively correlated with function levels measured by Global Assessment Scale (GAS), and associated with poor treatment responses.

Conclusion

: Symptom-based dimensional phenotypes of schizophrenia measured on a lifetime basis showed discriminative correlation with cognitive function domains, global functioning level, and overall treatment responses, indicating their possibility as valid phenotype axes of schizophrenia having homogeneous biologic basis.

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Table 1.

Demographic and clinical chara jects (n=103) acteristics of the sub

Variables
Sex (M: F), n	52: 51
Age (mean±S.D.), years	30.91±7.23
Education (mean±S.D.), years	14.17±2.17
Age of onset (mean±S.D.), years	22.92±5.96
Duration of illness (mean±S.D.), years	07.86±6.12
Number of admission (median), n	2
Subtype of schizophrenia at psychotic state, n (%)(n=101)
Paranoid	85 (84.2%)
Disorganized	05 (05.0%)
Catatonic	02 (02.0%)
Undifferentiated	09 (08.9%)

Table 2.

Correlation of lifetime symptom dimension scores with cognitive function

	Speed of processing	g Working memory	Verbal learning and memory	Visual learning and memory	Attention/ vigilance	Reasoning and problem solving	General cognitive ability	Intraindividual variability
Prodromal impairment factor	–0.19	–0.11	–0.05	–0.01	–0.04	–0.08	–0.12	–0.19
Negative symptom factor	–0.13	–0.17	–0.09	–0.09	–0.17	–0.13	–0.20∗	–0.07
Auditory hallucination factor	–0.15	–0.02	–0.01	–0.09	–0.08	–0.18	–0.09	–0.14
Schneiderian first-rank	–0.04	–0.04	–0.05	–0.06	–0.08	–0.14	–0.05	–0.09
symptom factor
Paranoid factor	–0.01	–0.14	–0.04	–0.01	–0.06	–0.06	–0.06	–0.03
Non-paranoid delusion factor	–0.26^†	–0.26^†	–0.12	–0.06	–0.20∗	–0.23	–0.30^†	–0.34^†
Somatic preoccupation factor	–0.03	–0.18	–0.08	–0.14	–0.07	–0.16	–0.14	–0.01
Disorganization factor	–0.13	–0.09	–0.16	–0.02	–0.02	–0.04	–0.02	–0.15

Pearson correlation analysis, age was entered as covariate (∗: p＜0.05, †: p＜0.01)

Table 3.

Correlation of lifetime symptom dimension scores with clinical characteristics

	GAS at worst point	CGI-I	Age of onset
Prodromal impairment factor	–0.04	–0.09	–0.01
Negative symptom factor	–0.29^†	–0.32^†	–0.05
Auditory hallucination factor	–0.24^†	–0.17^†	–0.01
Schneiderian first-rank symptom factor	–0.05	–0.08	–0.12∗
Paranoid factor	–0.03	–0.10	–0.05
Non-paranoid delusion factor	–0.22^†	–0.24^†	–0.03
Somatic preoccupation factor	–0.06	–0.05	–0.17^†
Disorganization factor	–0.09	–0.07	–0.06

Pearson correlation analysis (∗: p＜0.05, †: p＜0.01). GAS: Global Assessment Scale, CGI-I: Clinical Global Impression-Improvement scale, GAS at worst point: GAS score when patients were in their worst clinical state

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