BACKGROUND: As cognitive impairments are related to deficits in everyday functioning in schizophrenia, treatment of these impairments may have the potential to reduce these functional deficits. To determine if treatments truly reduce cognitive impairment, it is important to discriminate direct cognitive effects of treatment from generalized treatment benefits on the multiple clinical dimensions of schizophrenia. Thus, this study used a database from an existing clinical trial and examined the relationships between changes in clinical symptoms and cognitive deficits with several different strategies. MATERIALS AND METHODS: Two hundred and seventy stable but symptomatic outpatients with schizophrenia entered a study where they were switched from previous treatment to open-label ziprasidone. The present data are from the 6-month endpoint (n=184). Patients were examined at baseline and the 6-month endpoint with ratings of clinical symptoms based on the Positive and Negative Syndrome Scale (PANSS) and a neuropsychological (NP) assessment battery including aspects of cognitive functioning known to be related to functional outcome in schizophrenia. RESULTS: Changes on the individual PANSS items and NP test scores were examined with two separate principal components analyses, revealing four dimensions of clinical change (psychosis, negative symptoms, affective symptoms, and agitation) and two dimensions of NP improvement. Pearson correlations between changes in the (1) factors derived from the analyses, (2) individual NP items based the four clinical dimensions of change, and (3) the 30 PANSS items and the two NP dimensions of change suggested minimal relationships (largest r=0.15). IMPLICATIONS: This sample was selected because previous findings suggested that clinical and NP symptoms of schizophrenia significantly improved from baseline after a switch to ziprasidone treatment. While four dimensions of change in clinical symptoms and two dimensions of cognitive improvements were identified, clinical changes, regardless of how they were defined, were not related to NP improvements.
BACKGROUND: As cognitive impairments are related to deficits in everyday functioning in schizophrenia, treatment of these impairments may have the potential to reduce these functional deficits. To determine if treatments truly reduce cognitive impairment, it is important to discriminate direct cognitive effects of treatment from generalized treatment benefits on the multiple clinical dimensions of schizophrenia. Thus, this study used a database from an existing clinical trial and examined the relationships between changes in clinical symptoms and cognitive deficits with several different strategies. MATERIALS AND METHODS: Two hundred and seventy stable but symptomatic outpatients with schizophrenia entered a study where they were switched from previous treatment to open-label ziprasidone. The present data are from the 6-month endpoint (n=184). Patients were examined at baseline and the 6-month endpoint with ratings of clinical symptoms based on the Positive and Negative Syndrome Scale (PANSS) and a neuropsychological (NP) assessment battery including aspects of cognitive functioning known to be related to functional outcome in schizophrenia. RESULTS: Changes on the individual PANSS items and NP test scores were examined with two separate principal components analyses, revealing four dimensions of clinical change (psychosis, negative symptoms, affective symptoms, and agitation) and two dimensions of NP improvement. Pearson correlations between changes in the (1) factors derived from the analyses, (2) individual NP items based the four clinical dimensions of change, and (3) the 30 PANSS items and the two NP dimensions of change suggested minimal relationships (largest r=0.15). IMPLICATIONS: This sample was selected because previous findings suggested that clinical and NP symptoms of schizophrenia significantly improved from baseline after a switch to ziprasidone treatment. While four dimensions of change in clinical symptoms and two dimensions of cognitive improvements were identified, clinical changes, regardless of how they were defined, were not related to NP improvements.
Authors: Philip D Harvey; Barton W Palmer; Robert K Heaton; Somaia Mohamed; John Kennedy; Adam Brickman Journal: Am J Psychiatry Date: 2005-01 Impact factor: 18.112
Authors: Richard S E Keefe; Robert M Bilder; Philip D Harvey; Sonia M Davis; Barton W Palmer; James M Gold; Herbert Y Meltzer; Michael F Green; Del D Miller; Jose M Canive; Lawrence W Adler; Theo C Manschreck; Marvin Swartz; Robert Rosenheck; Diana O Perkins; Trina M Walker; T Scott Stroup; Joseph P McEvoy; Jeffrey A Lieberman Journal: Neuropsychopharmacology Date: 2006-04-19 Impact factor: 7.853
Authors: P D Harvey; M Davidson; L White; R S Keefe; J Hirschowitz; R C Mohs; K L Davis Journal: Biol Psychiatry Date: 1996-10-15 Impact factor: 13.382
Authors: Dawn I Velligan; John Newcomer; Joseph Pultz; John Csernansky; Anne L Hoff; Roderick Mahurin; Alexander L Miller Journal: Schizophr Res Date: 2002-01-15 Impact factor: 4.939
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Authors: Kimberley P Good; Jonathan Rabinowitz; David Whitehorn; Philip D Harvey; Goedele DeSmedt; Lili C Kopala Journal: Schizophr Res Date: 2004-05-01 Impact factor: 4.939
Authors: Bjørn Rishovd Rund; Helene Eidsmo Barder; Julie Evensen; Ulrik Haahr; Wenche ten Velden Hegelstad; Inge Joa; Jan Olav Johannessen; Johannes Langeveld; Tor Ketil Larsen; Ingrid Melle; Stein Opjordsmoen; Jan Ivar Røssberg; Erik Simonsen; Kjetil Sundet; Per Vaglum; Thomas McGlashan; Svein Friis Journal: Schizophr Bull Date: 2015-06-21 Impact factor: 9.306
Authors: Joseph Ventura; Gerhard S Hellemann; April D Thames; Vanessa Koellner; Keith H Nuechterlein Journal: Schizophr Res Date: 2009-07-22 Impact factor: 4.939