Neurocognitive Deficits in Remitted Cases of Schizophrenia: A Tertiary Hospital-Based Cross-Sectional Study
S. Chattopadhyay, K. ChakrabortyIntroduction
Cognitive deficits are one of the core symptoms of schizophrenia that evolve during the disease process. The cognitive domains mostly impaired are executive functions, memory, fluency, processing speed, working memory, attention, and delayed recall.
Objectives
In the index study, the authors included 70 remitted patients with schizophrenia [As per the operational criteria of Remission in Schizophrenia Working Group (RSWG) (2005) & the PAN-SS scale] & assessed them with the Addenbrooke’s Cognitive Examination– version III (ACE III) and the Montreal Cognitive Assessment Test (MoCA).
Methods
This cross-sectional observational study recruited 70 remitted patients (ICD-10; RSWG 2005) aged 18-50 years, who were literate in English/Hindi/Bengali, from the College of Medicine & JNM Hospital, Kalyani outpatient department (October 2022-October 2023). Patients having a history of dementia, stroke, intracranial operative procedure, autism, intellectual disability, and major neurological disorders & history of diabetes and hypertension for more than 10 years & patients having comorbid psychiatric disorders as per the Mini International Neuropsychiatric Interview (MINI)are excluded from the index study.
Study Instruments: Positive and negative syndrome in schizophrenia (PANSS) scale, Mini International Neuropsychiatric Interview (MINI), Addenbrooke’s Cognitive Examination-III (ACE III), Montreal Cognitive Assessment Test (MoCA). Data analysed with SPSS v22 using descriptive stats, correlations; p≤0.05 significant. Ethical clearance obtained.
Results
The mean positive symptom score (15.16 ± 2.48) was higher than the mean negative symptom score (13.51 ± 2.763) (PAN-SS). Overall, the most commonly reported symptoms were delusion (positive), passive social withdrawal & lack of spontaneity (negative) & unusual thought content (general psychopathological) in the study. On ACE III, more than four-fifths (82.9%) of the subjects showed abnormal deficits and severely compromised cognitive functions. Attention, language, and total ACE-III scores did not show a difference between genders, but the memory score was found to be higher in males (13.58 ± 5.22) compared to females (12.51 ± 3.53). Females had higher fluency rates (8.2968.29 ± 1.83) & visuospatial abilities (12.18 ± 3.31) compared to males. On MOCA, the language domain was the most affected. The majority of the samples had mild impairment (51.4%) in cognitive function.
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