Intelligence in schizophrenia: meta-analysis of the research.

This article combines a review and meta-analysis of research on IQ in schizophrenia, with emphasis on areas of convergence in the findings, as well as questions that remain to be answered. Taken together, the findings suggest that early-onset and adult-onset schizophrenia are associated with intellectual deficits across the lifespan. Preschizophrenic children, adolescents, and young adults perform below matched controls on a variety of standardized measures of intelligence. Significant IQ deficits are also apparent after the onset of the disorder. Moreover, IQ is positively related to several indices of prognosis, and, among hospitalized patients, there is negative within-subject covariance between intellectual performance and symptom severity. Although there is fairly consistent evidence that Verbal IQ is higher than Performance IQ among schizophrenic patients, a more specific pattern of subtest performance is not apparent. A central question raised by the results is whether IQ is an independently determined factor that can serve to mitigate the vulnerability of individuals who are constitutionally predisposed to schizophrenia, or whether intellectual deficit is one manifestation of the constitutional predisposition to the disorder. The findings also raise the question of possible sex differences in the developmental determinants of schizophrenia: Meta-analyses revealed that premorbid IQ deficits are more prevalent among males than females.

[1]  R. Lewine,et al.  Sex differences in schizophrenia: timing or subtypes? , 1981, Psychological bulletin.

[2]  S. Steinhauer,et al.  How to Break the Logjam in Schizophrenia: A Look Beyond Genetics , 1981, The Journal of nervous and mental disease.

[3]  J. Stabenau,et al.  Biological, psychological and historical differences in a series of monozygotic twins discordant for schizophrenia , 1968 .

[4]  D. Wechsler The Measurement Of Adult Intelligence , 1925 .

[5]  D. Klein,et al.  PERCEPTUAL EVIDENCE OF CNS DYSFUNCTION IN SCHIZOPHRENIA. , 1964, Archives of general psychiatry.

[6]  B. Stotsky A comparison of remitting and nonremitting schizophrenics on psychological tests. , 1952, Journal of abnormal psychology.

[7]  W. Davis,et al.  Relationships among WAIS subtest scores, patient's premorbid history, and institutionalization. , 1971, Journal of consulting and clinical psychology.

[8]  H C HAYWOOD,et al.  Effect of symptom change on intellectual function in schizophrenia. , 1963, Journal of abnormal and social psychology.

[9]  R. K. Hertel,et al.  Diagnostic Implications of Wisc Scores , 1970, Psychological reports.

[10]  E. Bower,et al.  SCHOOL CHARACTERISTICS OF MALE ADOLESCENTS WHO LATER BECAME SCHIZOPHRENIC , 1960 .

[11]  W. C. Shipley A Self-Administering Scale for Measuring Intellectual Impairment and Deterioration , 1940 .

[12]  D. Wechsler The measurement and appraisal of adult intelligence, 4th ed. , 1958 .

[13]  D. Hanson,et al.  Some Possible Childhood Indicators of Adult Schizophrenia Inferred from Children of Schizophrenics , 1976, British Journal of Psychiatry.

[14]  R. Hamlin THE STABILITY OF INTELLECTUAL FUNCTION IN CHRONIC SCHIZOPHRENIA , 1969, The Journal of nervous and mental disease.

[15]  H. L. Williams,et al.  Direct measurement of cognitive deficit in schizophrenia. , 1962, Journal of consulting psychology.

[16]  N C Andreasen,et al.  Negative v positive schizophrenia. Definition and validation. , 1982, Archives of general psychiatry.

[17]  M. Brody A SURVEY OF THE RESULTS OF INTELLIGENCE TESTS IN PSYCHOSIS1 , 1942 .

[18]  G. Albee,et al.  Intellectual Differences Between Suburban Preschizophrenic Children and Their Siblings. , 1967 .

[19]  R. Knight,et al.  Preschizophrenics: low IQ and aggressive symptoms as predictors of adult outcome and marital status. , 1980, Journal of Nervous and Mental Disease.

[20]  P. Harth,et al.  The influence of psychotic parents on their children's development. , 1972, The American journal of psychiatry.

[21]  R. Rosenthal Combining results of independent studies. , 1978 .

[22]  Distinctive features in psychological test measurements made upon dementia praecox and chronic alcoholic patients. , 1917 .

[23]  E. Emory,et al.  Infants at risk for psychopathology: offspring of schizophrenic parents. , 1983, Child development.

[24]  A. Stone,et al.  Cognitive Slippage in Children Vulnerable to Schizophrenia , 1978, Journal of abnormal child psychology.

[25]  C. F. Mason Pre-illness intelligence of mental hospital patients. , 1956, Journal of consulting psychology.

[26]  N. Watt,et al.  Childhood roots of schizophrenia. , 1976 .

[27]  G. Chelune,et al.  Level versus pattern of neuropsychological performance among schizophrenic and diffusely brain-damaged patients. , 1979, Journal of consulting and clinical psychology.

[28]  W. B. Webb,et al.  An attempt to study intellectual deterioration by premorbid and psychotic testing. , 1950, Journal of consulting psychology.

[29]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[30]  R. Knight,et al.  DISTURBED PRESCHIZOPHRENICS: CHILDHOOD SYMPTOMS IN RELATION TO ADULT OUTCOME , 1976, The Journal of nervous and mental disease.

[31]  L. J. Chapman,et al.  Problems in the measurement of cognitive deficit. , 1973, Psychological bulletin.

[32]  A. Schwartzman,et al.  Intellectual loss in schizophrenia: Part II. , 1962 .

[33]  G. Albee,et al.  Childhood and intercurrent intellectual performance of adult schizophrenics. , 1963, Journal of consulting psychology.

[34]  C. G. Watson WAIS PROFILE PATTERNS OF HOSPITALIZED BRAIN-DAMAGED AND SCHIZOPHRENIC PATIENTS. , 1965, Journal of clinical psychology.

[35]  A. Smith MENTAL DETERIORATION IN CHRONIC SCHIZOPHRENIA , 1964, The Journal of nervous and mental disease.

[36]  R. Knight,et al.  A factor-analytic study of childhood symptoms antecedent to schizophrenia. , 1976, Journal of abnormal psychology.

[37]  H. Grunebaum,et al.  Disturbance of attention among schizophrenic, depressed and well mothers and their young children. , 1977, Journal of child psychology and psychiatry, and allied disciplines.

[38]  G. Albee,et al.  CHILDHOOD INTELLIGENCE OF FUTURE SCHIZOPHRENICS AND NEIGHBORHOOD PEERS. , 1964, The Journal of psychology.

[39]  W. Davis,et al.  Intellectual deficit in process and reactive schizophrenia and brain injury. , 1972, Journal of consulting and clinical psychology.

[40]  E. Walker,et al.  Intra- and interhemispheric information processing in schizophrenia. , 1982, Psychological bulletin.

[41]  B. M. Drillien,et al.  The Growth and Development of the Prematurely Born Infant , 1965 .

[42]  J. Birren Psychological examinations of children who later became psychotic , 1944 .

[43]  M. Wentworth Two Hundred Cases of Dementia Precox Tested by the Stanford Revision. , 1924 .

[44]  C. G. Watson,et al.  Multivariate analysis of WAIS-MMPI relationships among brain-damaged, schizophrenic, neurotic, and alcoholic patients. , 1980, Journal of clinical psychology.

[45]  A. Roe,et al.  INTELLIGENCE IN MENTAL DISORDER , 1942 .

[46]  R. Rubin,et al.  Measures of Infant Development and Socioeconomic Status as Predictors of Later Intelligence and School Achievement. , 1979 .

[47]  D. Offord,et al.  Independent Transmission of IQ and Schizophrenia , 1975, British Journal of Psychiatry.

[48]  H. Klonoff,et al.  NEUROPSYCHOLOGICAL, PATTERNS IN CHRONIC SCHIZOPHRENIA , 1970, The Journal of nervous and mental disease.

[49]  A. Dewolfe,et al.  Intellectual deficit in chronic schizophrenia and brain damage. , 1971, Journal of consulting and clinical psychology.

[50]  Richard J. Haier,et al.  Schizophrenia: The epigenetic puzzle Cambridge University Press, Cambridge (1982). 258 pp. by Irving I. Gottesman and James Shields , 1982, Psychiatry Research.

[51]  L. Coyne,et al.  Phenothiazine effects on psychological and psychophysiological dysfunction in chronic schizophrenics. , 1977, Archives of general psychiatry.

[52]  H. Goldstein,et al.  From Birth to Seven , 1972 .

[53]  G. Chelune,et al.  Level and variability of performance on neuropsychological tests. , 1979, Journal of clinical psychology.

[54]  S. Mednick,et al.  Verbal associative disturbances in children at high risk for schizophrenia. , 1980, Journal of abnormal psychology.

[55]  D. Offord,et al.  Adult schizophrenia with scholastic failure or low IQ in childhood. A preliminary report. , 1971, Archives of general psychiatry.

[56]  L. Erlenmeyer‐Kimling,et al.  Social, emotional, and intellectual behavior at school among children at high risk for schizophrenia. , 1982, Journal of consulting and clinical psychology.

[57]  H. Hunt A practical, clinical test for organic brain damage. , 1943 .

[58]  G. Albee,et al.  CHILDHOOD INTELLECTUAL DIFFERENCES BETWEEN SCHIZOPHRENIC ADULTS AND THEIR SIBLINGS. , 1965, The American journal of orthopsychiatry.

[59]  D. Saccuzzo,et al.  Effect of antipsychotic medication on speed of information processing in schizophrenic patients. , 1982, The American journal of psychiatry.

[60]  D. Wechsler,et al.  SCHIZOPHRENIC PATTERNS ON THE WISC. , 1965, Journal of clinical psychology.

[61]  M. Pollack Comparison of childhood, adolescent, and adult schizophrenias. Etiologic significance of intellectual functioning. , 1960, A.M.A. archives of general psychiatry.

[62]  J. Miner,et al.  Intelligence and emotional disturbance: evidence from Army and Veterans Administration records. , 1958, Journal of abnormal psychology.

[63]  M. Strauss,et al.  Rehospitalization of schizophrenics as a function of intelligence. , 1975, Journal of abnormal psychology.

[64]  D. Offord,et al.  School Performance of Adult Schizophrenics, Their Siblings and Age Mates , 1974, British Journal of Psychiatry.

[65]  C. G. Watson,et al.  Multivariate structure of associations between verbal and nonverbal intelligence among brain-damaged, schizophrenic, neurotic, and alcoholic patients. , 1979, Journal of abnormal psychology.

[66]  The Intelligence of Children of Schizophrenics. , 1970 .

[67]  A. Binder Schizophrenic intellectual impairment: uniform or differential? , 1956, Journal of abnormal psychology.

[68]  V. Hesselbrock,et al.  The intelligence of children and their parents with schizophrenia and affective illness. , 1980, Journal of child psychology and psychiatry, and allied disciplines.

[69]  G. Fleming Psychological Studies in Dementia Praecox , 1940 .

[70]  F. L. Wells,et al.  INTELLIGENCE AND PSYCHOSIS , 1920 .

[71]  D. Klein,et al.  A three-year posthospital follow-up of adolescent and adult schizophrenics. , 1968, The American journal of orthopsychiatry.

[72]  G. Albee,et al.  Childhood intellectual development of adult schizophrenics. , 1963, Journal of abnormal and social psychology.

[73]  M. Davidson STUDIES IN THE APPLICATION OF MENTAL TESTS TO PSYCHOTIC PATIENTS , 1939 .

[74]  D. G. Weeks,et al.  Longitudinal, prospective evaluations of intelligence in children at risk. , 1982, Schizophrenia bulletin.

[75]  Performance on the Wechsler-Bellevue scale and insulin shock therapy. , 1950, Journal of abnormal psychology.

[76]  S. Broman,et al.  The offspring of schizophrenics. II. Perinatal factors and IQ. , 1977, Archives of general psychiatry.

[77]  G. Goldstein,et al.  Neuropsychological differences among subtypes of schizophrenia. , 1977, Journal of abnormal psychology.

[78]  P. Flor-Henry LATERALIZED TEMPORAL‐LIMBIC DYSFUNCTION AND PSYCHOPATHOLOGY * , 1976 .

[79]  A. Stone,et al.  Cognitive and attentional deficits in children vulnerable to psychopathology , 1981, Journal of abnormal child psychology.

[80]  G. Albee,et al.  On childhood intellectual decline of adult schizophrenics: a reassessment of an earlier study. , 1968, Journal of abnormal psychology.

[81]  C. L. Winder Some Psychological Studies of Schizophrenics. , 1960 .

[82]  Helen Elizabeth Frazee Children who later became schizophrenic 1 , 1953 .

[83]  M. Bleuler The offspring of schizophrenics. , 1974, Schizophrenia bulletin.

[84]  H. Grunebaum,et al.  Children of depressed and schizophrenic mothers , 1978, Child psychiatry and human development.

[85]  G. Albee,et al.  EARLY CHILDHOOD INTELLECTUAL DIFFERENCES BETWEEN SCHIZOPHRENIC ADULTS AND THEIR SIBLINGS. , 1964, Journal of abnormal psychology.

[86]  Marshall B. Jones IQ and Fertility in Schizophrenia , 1973, British Journal of Psychiatry.