Symptoms versus neurocognitive test performance as predictors of psychosocial status in schizophrenia: a 1- and 4-year prospective study.

In recent years, a growing body of literature has highlighted the significance of neurocognitive deficits as markers for subsequent psychosocial deficits in patients with schizophrenia. Relatively few studies, however, have directly compared symptoms and neurocognitive test performance as predictors of psychosocial status in a prospective design. In two studies with schizophrenia patients, we investigated the relationship between symptom dimensions (psychomotor poverty, disorganization, reality distortion) and neurocognitive measures (problem solving, attention, verbal learning and memory) obtained at study entry, and psychosocial status measured at a 1- and 4-year followup. Results from the 1-year followup (n = 70) revealed that psychomotor poverty, symptoms of disorganization, and performance on measures of card-sorting and visual vigilance were related to psychosocial status. Results from the 4-year followup (n = 26) revealed a similar pattern of findings with the exception of verbal learning, which emerged as a predictor of psychosocial status only at the 4-year followup. Stepwise regression revealed that performance on measures of visual vigilance and psychomotor poverty symptoms explained the largest amount of variance in psychosocial status at both followup intervals. The significance of these findings for the development and assessment of novel treatment interventions for schizophrenia is discussed.