Neurocognitive insight and objective cognitive functioning in schizophrenia

SCHIZOPHRENIA RESEARCH

卷:171

Article

Burton, Cynthia Z.^1,6  Harvey, Philip D.^2,3  Patterson, Thomas L.⁴  Twamley, Elizabeth W.^4,5 

[1] SDSU UCSD Joint Doctoral Program Clin Psychol, 6363 Alvarado Court, San Diego, CA 92120 USA

[2] Univ Miami, Dept Psychiat & Behav Sci, Miller Sch Med, 1120 NW 14th St,Suite 1450, Miami, FL 33136 USA

[3] Miami VA Healthcare Syst, Res Serv, 1201 NW 16th St, Miami, FL 33125 USA

[4] Univ Calif San Diego, Dept Psychiat, 9500 Gilman Dr,MC 0603, La Jolla, CA 92093 USA

[5] VA San Diego Healthcare Syst, Ctr Excellence Stress & Mental Hlth, 3350 La Jolla Village Dr,116A, San Diego, CA 92161 USA

[6] Univ Michigan, Dept Psychiat, 4250 Plymouth Rd, Ann Arbor, MI 48109 USA

关键词: Cognition;    Awareness;    Psychosis;    Functional capacity;   

DOI  :  10.1016/j.schres.2016.01.021

来源: Elsevier

【 摘 要 】

Neurocognitive impairment is a core component of schizophrenia affecting everyday functioning; the extent to which individuals with schizophrenia show awareness of neurocognitive impairment (neurocognitive insight) is unclear. This study investigated neurocognitive insight and examined the cross-sectional relationships between neurocognitive insight and objective neurocognition and functional capacity performance in a large outpatient sample. 214 participants with schizophrenia-spectrum disorders completed measures of neurocognition, functional capacity, and self-reported neurocognitive problems. Latent profile analysis classified participants with regard to neuropsychological performance and self-report of neurocognitive problems. The resulting classes were then compared on executive functioning performance, functional capacity performance, and psychiatric symptom severity. More than three quarters of the sample demonstrated objective neurocognitive impairment (global deficit score >= 0.50). Among the participants with neurocognitive impairment, 54% were classified as having impaired neurocognitive insight (i.e., reporting few neurocognitive problems despite having objective neurocognitive impairment). Participants with impaired vs. intact neurocognitive insight did not differ on executive functioning measures or measures of functional capacity or negative symptom severity, but those with intact neurocognitive insight reported higher levels of positive and depressive symptoms. A substantial portion of individuals with schizophrenia and objectively measured neurocognitive dysfunction appear unaware of their deficits. Patient self-report of neurocognitive problems, therefore, is not likely to reliably assess neurocognition. Difficulty self-identifying neurocognitive impairment appears to be unrelated to executive functioning, negative symptoms, and functional capacity. For those with intact neurocognitive insight, improving depressive and psychotic symptoms may be a valuable target to reduce illness burden. Published by Elsevier B.V.

【 授权许可】

Free