Longitudinal studies of cognition in schizophrenia: Meta-analysis

Background A wide range of cognitive deficits have been demonstrated in schizophrenia, but their longitudinal course remains unclear. Aims To bring together all the available information from longitudinal studies of cognitive performance in people with schizophrenia. Method We carried out a meta-analysis of 53 studies. Unlike previous reviewers, we included all studies (regardless of the type of medication), analysed each variable separately and compared results with data from controls. Results Participants with schizophrenia showed a significant improvement in most cognitive tasks. The available data for controls showed, with one exception (the Stroop test), a similar or greater improvement. Performance in semantic verbal fluency remained stable in both individuals with schizophrenia and controls. Conclusions Participants with schizophrenia displayed improvement in most cognitive tasks, but practice was more likely than cognitive remediation to account for most of the improvements observed. Semantic verbal fluency may be the best candidate cognitive endophenotype.

[1]  C. Marvel,et al.  Adjuvant Topiramate Administration: A Pharmacologic Strategy for Addressing NMDA Receptor Hypofunction in Schizophrenia , 2003, Clinical neuropharmacology.

[2]  H. Westervelt,et al.  Practitioner’s Guide to Evaluating Change with Intellectual Assessment Instruments , 2000, Critical Issues in Neuropsychology.

[3]  T. Patterson,et al.  Neuroleptic dose reduction in older psychotic patients , 1997, Schizophrenia Research.

[4]  A. Labelle,et al.  Neuropsychological change in schizophrenia after 6 weeks of clozapine , 2001, Schizophrenia Research.

[5]  Cameron S Carter,et al.  Cognitive deficits in unaffected first-degree relatives of schizophrenia patients: a meta-analytic review of putative endophenotypes. , 2005, Schizophrenia bulletin.

[6]  M. Strauss,et al.  Relation of neuroleptic and anticholinergic medication to cognitive functions in schizophrenia. , 1989, Journal of abnormal psychology.

[7]  S. Lewis,et al.  Neurocognitive function and outcome in first-episode schizophrenia: a 10-year follow-up of an epidemiological cohort , 2003, Schizophrenia Research.

[8]  Veena Kumari,et al.  Longitudinal study of symptoms and cognitive function in chronic schizophrenia , 2003, Schizophrenia Research.

[9]  J. Sweeney,et al.  Pretreatment and longitudinal studies of neuropsychological deficits in antipsychotic-naı̈ve patients with schizophrenia , 2004, Schizophrenia Research.

[10]  Konstantine K. Zakzanis,et al.  Neurocognitive Deficit in Schizophrenia: A Quantitative Review of the Evidence , 1998 .

[11]  J. Lieberman,et al.  The effects of atypical antipsychotic drugs on neurocognitive impairment in schizophrenia: a review and meta-analysis. , 1999, Schizophrenia bulletin.

[12]  N. Andreasen,et al.  Longitudinal study of cognitive function in first-episode and recent-onset schizophrenia. , 1999, The American journal of psychiatry.

[13]  H. Westervelt,et al.  Practitioner’s Guide to Evaluating Change with Neuropsychological Assessment Instruments , 2012, Critical Issues in Neuropsychology.

[14]  S. Faraone,et al.  Neuropsychological performance in chronic schizophrenia in response to neuroleptic dose reduction , 1993, Biological Psychiatry.

[15]  R. Catalán,et al.  Cognitive mechanisms, psychosocial functioning, and neurocognitive rehabilitation in schizophrenia , 2003, Schizophrenia Research.

[16]  R. Heinrichs,et al.  Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. , 1998, Neuropsychology.

[17]  T. Goldberg,et al.  The Effect of Clozapine on Cognition and Psychiatric Symptoms in Patients with Schizophrenia , 1993, British Journal of Psychiatry.

[18]  T. Goldberg,et al.  Letter and category fluency in schizophrenic patients: a meta-analysis , 2003, Schizophrenia Research.

[19]  S. Thompson,et al.  Quantifying heterogeneity in a meta‐analysis , 2002, Statistics in medicine.

[20]  Streichenwein Sm,et al.  Am J Psychiatry , 1996 .

[21]  Y. Chan,et al.  The effect of risperidone on cognitive functioning in a sample of Asian patients with schizophrenia in Singapore. , 2001, Singapore medical journal.

[22]  B. Maher,et al.  Effects of clozapine on psychiatric symptoms, cognition, and functional outcome in schizophrenia. , 1999, The Journal of neuropsychiatry and clinical neurosciences.

[23]  O. Wolkowitz,et al.  The Effects of Clozapine on Symptom Reduction, Neurocognitive Function, and Clinical Management in Treatment-Refractory State Hospital Schizophrenic Inpatients , 1996, Neuropsychopharmacology.

[24]  J. Henry,et al.  A meta-analytic review of verbal fluency deficits in schizophrenia relative to other neurocognitive deficits , 2005, Cognitive neuropsychiatry.

[25]  S. Marder,et al.  Does risperidone improve verbal working memory in treatment-resistant schizophrenia? , 1997, The American journal of psychiatry.

[26]  R. McCarley,et al.  Wisconsin card sorting test performance over time in schizophrenia Preliminary evidence from clinical follow-up and neuroleptic reduction studies , 1991, Schizophrenia Research.

[27]  A. Malla,et al.  Neuropsychological change in patients with schizophrenia after treatment with quetiapine or haloperidol. , 2001, Journal of psychiatry & neuroscience : JPN.

[28]  H. Verdoux,et al.  Neuroleptic effects on neuropsychological test performance in schizophrenia , 1995, Schizophrenia Research.

[29]  J. Sweeney,et al.  Evaluation of the stability of neuropsychological functioning after acute episodes of schizophrenia: One-year followup study , 1991, Psychiatry Research.

[30]  N. Mimica,et al.  A preliminary study of the comparative effects of olanzapine and fluphenazine on cognition in schizophrenic patients , 2000, Human psychopharmacology.

[31]  Harris Cooper,et al.  Conducting a Meta-Analysis , 2006 .

[32]  T. Goldberg,et al.  Further evidence for dementia of the prefrontal type in schizophrenia? A controlled study of teaching the Wisconsin Card Sorting Test. , 1987, Archives of general psychiatry.

[33]  T. Sharma,et al.  Cognitive effects of olanzapine and clozapine treatment in chronic schizophrenia , 2003, Psychopharmacology.

[34]  Alexander L. Miller,et al.  Does cognitive function improve with quetiapine in comparison to haloperidol? , 2002, Schizophrenia Research.

[35]  B. Rund,et al.  A review of longitudinal studies of cognitive functions in schizophrenia patients. , 1998, Schizophrenia bulletin.

[36]  J. Gold.  Cognitive deficits as treatment targets in schizophrenia , 2004, Schizophrenia Research.

[37]  Winston Bennett,et al.  Conducting Meta-Analysis Using SAS , 2001 .

[38]  R. Gråwe,et al.  Neuropsychological impairments in patients with schizophrenia: stability and prediction of outcome , 2001, Acta psychiatrica Scandinavica. Supplementum.

[39]  J. Lieberman,et al.  11. Neuropsychological deficits in the early course of first episode schizophrenia , 1991, Schizophrenia Research.

[40]  Marion Leboyer,et al.  Tests of executive functions in first-degree relatives of schizophrenic patients: a meta-analysis , 2004, Psychological Medicine.

[41]  T. McBride,et al.  Medicare Part D: early findings on enrollment and choices for rural beneficiaries. , 2006, Rural policy brief.

[42]  H. Nyman,et al.  Stability of performance on neuropsychological tests in patients with schizophrenia , 1999, European Archives of Psychiatry and Clinical Neuroscience.

[43]  Alessandro Rossi,et al.  Risperidone, negative symptoms and cognitive deficit in schizophrenia: an open study , 1997 .

[44]  Steven G Potkin,et al.  Improvement in cognitive function following a switch to ziprasidone from conventional antipsychotics, olanzapine, or risperidone in outpatients with schizophrenia , 2004, Schizophrenia Research.

[45]  A. Morris.  William Battie's Treatise on Madness (1758) and John Monro's Remarks on Dr Battie's Treatise (1758) – 250 years ago , 2008, British Journal of Psychiatry.

[46]  L. DeLisi,et al.  Ten year longitudinal study of neuropsychological functioning subsequent to a first episode of schizophrenia , 2005, Schizophrenia Research.

[47]  M. Bell,et al.  Longitudinal Wisconsin Card Sorting Performance in Schizophrenia Patients in Rehabilitation , 2002, Applied neuropsychology.

[48]  Philip D. Harvey,et al.  Stability of cognitive performance in older patients with schizophrenia: an 8-week test-retest study. , 2005, The American journal of psychiatry.

[49]  V. Peralta,et al.  Effects of olanzapine and other antipsychotics on cognitive function in chronic schizophrenia: a longitudinal study , 2001, Schizophrenia Research.

[50]  R. Liberman,et al.  A controlled trial of cognitive remediation in schizophrenia. , 2002, Schizophrenia bulletin.

[51]  Thomas E. Smith,et al.  Recovery from psychosis in schizophrenia and schizoaffective disorder: symptoms and neurocognitive rate-limiters for the development of social behavior skills , 2002, Schizophrenia Research.

[52]  S. McGurk,et al.  Cognitive and symptom predictors of work outcomes for clients with schizophrenia in supported employment. , 2003, Psychiatric services.

[53]  Herbert Y Meltzer,et al.  A meta-analysis of neuropsychological change to clozapine, olanzapine, quetiapine, and risperidone in schizophrenia. , 2005, The international journal of neuropsychopharmacology.

[54]  L. DeLisi,et al.  A prospective follow-up study of brain morphology and cognition in first-episode schizophrenic patients: Preliminary findings , 1995, Biological Psychiatry.

[55]  N. Laird,et al.  Meta-analysis in clinical trials. , 1986, Controlled clinical trials.

[56]  Z. Mahmood,et al.  The Scottish First Episode Schizophrenia Study V. One-year Follow-up , 1988, British Journal of Psychiatry.

[57]  I. Ahmed,et al.  The effects of clozapine on cognitive functioning in treatment-resistant schizophrenic patients. , 1997, The Journal of neuropsychiatry and clinical neurosciences.

[58]  N. Andreasen,et al.  Stability of cognitive functioning early in the course of schizophrenia , 1994, Schizophrenia Research.

[59]  Xiao-Hua Zhou,et al.  Statistical Methods for Meta‐Analysis , 2008 .

[60]  Philip D. Harvey,et al.  Cognitive impairment and negative symptoms in geriatric chronic schizophrenic patients: a follow-up study , 1996, Schizophrenia Research.

[61]  G. Remington,et al.  A Canadian Multicenter Trial Assessing Memory and Executive Functions in Patients With Schizophrenia Spectrum Disorders Treated With Olanzapine , 2003, Journal of clinical psychopharmacology.

[62]  Wolfgang Gaebel,et al.  Impaired Trail-Making Test-B performance in patients with acute schizophrenia is related to inefficient sequencing of planning and acting. , 2002, Journal of psychiatric research.

[63]  L. Friedman,et al.  Improvement in cognitive functions and psychiatric symptoms in treatment-refractory schizophrenic patients receiving clozapine , 1993, Biological Psychiatry.

[64]  D. Barclay,et al.  One-year follow-up , 1975 .

[65]  J. Lieberman,et al.  Neuropsychological deficits in the early course of first episode schizophrenia. , 1991, Schizophrenia research.

[66]  Philip D. Harvey,et al.  Studies of cognitive change in patients with schizophrenia following novel antipsychotic treatment. , 2001, The American journal of psychiatry.

[67]  R. Buchanan,et al.  The comparative efficacy and long-term effect of clozapine treatment on neuropsychological test performance , 1994, Biological Psychiatry.

[68]  Philip D. Harvey,et al.  The longitudinal relationship of clinical symptoms, cognitive functioning, and adaptive life in geriatric schizophrenia , 2000, Schizophrenia Research.

[69]  M. Strauss,et al.  Test-retest reliability of information-processing measures among chronic schizophrenics , 1986, Psychiatry Research.

[70]  R. Fields,et al.  Clonidine improves memory function in schizophrenia independently from change in psychosis Preliminary findings , 1988, Schizophrenia Research.

[71]  B. Rund.  Distractibility and recall capability in schizophrenics A 4 year longitudinal study of stability in cognitive performance , 1989, Schizophrenia Research.

[72]  A. Malla,et al.  Changes in cognitive functioning following comprehensive treatment for first episode patients with schizophrenia spectrum disorders , 2002, Psychiatry Research.

[73]  Brian Sheitman,et al.  Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients with chronic schizophrenia or schizoaffective disorder. , 2002, The American journal of psychiatry.

[74]  Michael F. Green,et al.  The neurocognitive effects of low-dose haloperidol: a two-year comparison with risperidone , 2002, Biological Psychiatry.

[75]  R. de Beaurepaire,et al.  Bromocriptine improves digit symbol substitution test scores in neuroleptic-treated chronic schizophrenic patients , 1993, European Psychiatry.

[76]  M. Bell,et al.  Insight and Cognitive Impairment in Schizophrenia Performance on Repeated Administrations of the Wisconsin Card Sorting Test , 1994, The Journal of nervous and mental disease.

[77]  R. Gibbons,et al.  Effects of psychotropic medication on selected cognitive and perceptual measures. , 1984, Journal of abnormal psychology.

[78]  M. Albus,et al.  A prospective 2-year follow-up study of neurocognitive functioning in patients with first-episode schizophrenia , 2002, European Archives of Psychiatry and Clinical Neuroscience.

[79]  A. Clair,et al.  Performance on tests sensitive to impaired executive ability in schizophrenia, mania and well controls: acute and subacute phases , 1997, Schizophrenia Research.

[80]  A Labelle,et al.  Neuropsychological change in early phase schizophrenia during 12 months of treatment with olanzapine, risperidone, or haloperidol. The Canadian Collaborative Group for research in schizophrenia. , 2000, Archives of general psychiatry.