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Cognitive dysfunction in chronic schizophrenia followed prospectively over 10 years and its longitudinal relationship to the emergence of tardive dyskinesia

  • John L. Waddington (a1) and Hanafy A. Youssef (a1)
Synopsis
Synopsis

Basic cognitive function was assessed at initial and at 5- and 10-year follow-up assessments among 41 primarily middle-aged in-patients manifesting the severest form of schizophrenia; additionally, the presence and severity of tardive dyskinesia was evaluated on each occasion. Overall, there was a modest but significant deterioration in cognitive function over the decade, particularly among older men. Longitudinally, patients with persistent tardive (orofacial) dyskinesia continued to show poorer cognitive function than those consistently without such movement disorder, though within neither group did cognitive function change over the decade. Those patients demonstrating prospectively the emergence of orofacial dyskinesia showed a marked deterioration in their cognitive function over the same time-frame within which their movement disorder emerged, but this decline did not progress further thereafter. There appears to exist some modest, progressive deterioration in cognitive function even late in the chronic phase of severe schizophrenic illness which appears to derive primarily from patients showing de novo emergence of tardive orofacial dyskinesia.

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Corresponding author
1Address for correspondence: Professor John L. Waddington, Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin 2, Ireland
References
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Barnes T. R. E. (1990). Movement disorder associated with antipsychotic drugs: the tardive syndromes. International Review of Psychiatry 2, 243254.
Bilder R. M., Lipschutz-Broch L., Reiter G., Geisler S. H., Mayerhoff D. I. & Lieberman J. A. (1992). Intellectual deficits in first-episode schizophrenia: evidence for progressive deterioration. Schizophrenia Bulletin 18, 437448.
Blanchard J. J. & Neale J. M. (1994). The neuropsychological signature of schizophrenia: generalized or differential deficit? American Journal of Psychiatry 151, 4048.
Buckwalter J. G., Sobel E., Dunn M. E., Diz M. M. & Henderson V. W. (1993). Gender differences on a brief measure of cognitive functioning in Alzheimer's disease. Archives of Neurology 50, 757760.
Buhrich N., Crow T. J., Johnstone E. C. & Owens D. G. C. (1988). Age disorientation in chronic schizophrenia is not associated with premorbid intellectual impairment or past physical treatment. British Journal of Psychiatry 152, 466469.
Casanova M. F., Carosella N. W., Gold J. M., Kleinman J. E., Weinberger D. R. & Powers R. E. (1992). A topographical study of senile plaques and neurofibrillary tangles in the hippocampi of patients with Alzheimer's disease and cognitively impaired patients with schizophrenia. Psychiatry Research 49, 4162.
Davis J. M. (1976). Comparative doses and costs of antipsychotic medication. Archives of General Psychiatry 33, 858861.
Edwards H. (1970). The significance of brain damage in persistent oral dyskinesia. British Journal of Psychiatry 116, 271275.
Feighner J. P., Robins E., Guze S. B., Woodruff R. A., Winokur G. & Munoz R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 5763.
Fenton W. S., Wyatt R. J. & McGlashan T. H. (1994). Risk factors for spontaneous dyskinesia in schizophrenia. Archives of General Psychiatry 51, 643650.
Goldberg T. E., Hyde T. M., Kleinman J. E. & Weinberger D. R. (1993). Course of schizophrenia: neuropsychological evidence for a static encephalopathy. Schizophrenia Bulletin 19, 797804.
Goldstein J. M. (1988). Gender differences in the course of schizophrenia. American Journal of Psychiatry 145, 684689.
Haroutunian V., Davidson M., Kanof P. D., Perl D. P., Powchik P., Losonczy M., McCrystal J., Purohit D. P., Bierer L. M. & Davis K. (1994). Cortical cholinergic markers in schizophrenia. Schizophrenia Research 12, 137144.
Heaton R. K. & Drexler M. (1987). Clinical neuropsychological findings in schizophrenia and aging. In Schizophrenia and Aging (ed. Miller N. E. and Cohen G. D.), pp. 145161. Guilford Press: New York.
Heaton R., Paulsen J. S., McAdams L. A., Kuck J., Zisook S., Braff D., Harris M. J. & Jeste D. V. (1994). Neuropsychological deficits in schizophrenics: relationship to age, chronicity and dementia. Archives of General Psychiatry 51, 469476.
Hoff A. L., Riordan H., O'Donnell D. W., Morris L. & DeLisi L. E. (1992). Neuropsychological functioning in first episode schizophreniform patients. American Journal of Psychiatry 149, 898903.
Hyde T. M., Nawroz S., Goldberg T. E., Bigelow L. B., Strong D., Ostrem J. L., Weinberger D. R. & Kleinman J. E. (1994). Is there cognitive decline in schizophrenia? A cross-sectional study. British Journal of Psychiatry 164, 494500.
Kraepelin E. (1919). Dementia Praecox and Paraphrenia (translated by Barclay R. M.). Robert E. Kreiger: New York. (1971).
National Institute of Mental Health (1976). Abnormal involuntary movement scale. In ECDEU Assessment Manual (ed. Guy W.), pp. 534537. US Department of Health, Education and Welfare: Rockville.
Owens D. G. C., Johnstone E. C. & Frith C. D. (1982). Spontaneous involuntary disorders of movement: their prevalence, severity, and distribution in chronic schizophrenics with and without treatment with neuroleptics. Archives of General Psychiatry 39, 452461.
Purohit D. P., Davidson M., Perl D. P., Powchik P., Haroutunian V. H., Bierer L. M., McCrystal J., Losonczy M. & Davis K. L. (1993). Severe cognitive impairment in elderly schizophrenic patients: a clinicopathological study. Biological Psychiatry 33, 255260.
Rogers D. (1985). The motor disorders of severe psychiatric illness: the conflict of paradigms. British Journal of Psychiatry 47, 221232.
Saykin A. J., Shtasel D. L., Gur R. E., Kester D. B., Mozley L. H., Stafinak P. & Gur R. C. (1994). Neuropsychological deficits in neuroleptic naive patients with first-episode schizophrenia. Archives of General Psychiatry 51, 124131.
Shtasel D. L., Gur R. E., Gallacher F., Heimberg C. & Gur R. C. (1992). Gender differences in the clinical expression of schizophrenia. Schizophrenia Research 7, 225231.
Stern R. G., Mohs R. C., Davidson M., Schmeidler J., Silverman J., Kramer-Ginsberg E., Searcey T., Bierer L. & Davis K. L. (1994). A longitudinal study of Alzheimer's disease: measurement, rate and predictors of cognitive deterioration. American Journal of Psychiatry 151, 390396.
Waddington J. L. (1989). Schizophrenia, affective psychoses and other disorders treated with neuroleptic drugs: the enigma of tardive dyskinesia, its neurobiological determinants and the conflict of paradigms. International Review of Neurobiology 31, 297353.
Waddington J. L. (1993 a). Schizophrenia: developmental neuroscience and pathobiology. Lancet 341, 531536.
Waddington J. L. (1993 b). Neurodynamics of abnormalities in cerebral metabolism and structure in schizophrenia. Schizophrenia Bulletin 19, 5569.
Waddington J. L. (1995). Psychopathological and cognitive correlates of tardive dyskinesia in schizophrenia and other disorders treated with neuroleptic drugs. In Behavioral Neurology of Movement Disorders (ed. Weiner W. J. and Lang A. E.), pp. 211229. Raven Press: New York.
Waddington J. L. & Youssef H. A. (1986). An unusual cluster of tardive dyskinesia in schizophrenia: association with cognitive dysfunction and negative symptoms. American Journal of Psychiatry 143, 11621165.
Waddington J. L., Youssef H. A., Dolphin C. & Kinsella A. (1987). Cognitive dysfunction, negative symptoms and tardive dyskinesia in schizophrenia: their association in relation to topography of involuntary movements and criterion of their abnormality. Archives of General Psychiatry 44, 907912.
Waddington J. L., Youssef H. A. & Kinsella A. (1990). Cognitive dysfunction in schizophrenia followed up over 5 years, and its longitudinal relationship to the emergence of tardive dyskinesia. Psychological Medicine 20, 835842.
Waddington J. L., O'Callaghan E., Larkin C. & Kinsella A. (1993). Cognitive dysfunction in schizophrenia: organic vulnerability factor or state marker for tardive dyskinesia? Brain and Cognition 23, 5670.
Waddington J. L., Youssef H. A. & Kinsella A. (1995 a). Sequential cross-sectional and 10-year prospective study of severe negative symptoms in relation to duration of initially untreated psychosis in chronic schizophrenia. Psychological Medicine 25, 849857.
Waddington J. L., O'Callaghan E., Buckley P., Madigan C., Redmond O., Stack J. P., Kinsella A., Larkin C. & Ennis J. T. (1995 b). Tardive dyskinesia in schizophrenia: relationship to minor physical anomalies, frontal lobe dysfunction and cerebral structure on magnetic resonance imaging. British Journal of Psychiatry 167, 4144.
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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
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