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Executive dysfunction in first-episode schizophrenia and relationship to duration of untreated psychosis: The West London Study

  • Eileen Joyce (a1), Sam Hutton (a1), Stan Mutsatsa (a1), Heidi Gibbins (a1), Emma Webb (a1), Sonja Paul (a1), Trevor Robbins (a2) and Thomas Barnes (a1)...

Abstract

Background

Many studies have demonstrated early generalised cognitive impairment in schizophrenia.

Aims

To examine executive function in first-episode schizophrenia, characterise the nature of the impairment and specify any relationships with symptoms and duration of untreated psychosis (DUP).

Method

Patients (n=136) and normal controls (n=81) were assessed with the Cambridge Automated Neuropsychological Test Battery, National Adult Reading Test IQ, and Scales for the Assessment of Positive and Negative Symptoms.

Results

Memory and executive impairments in patients were independent of IQ level. Spatial working memory was impaired because of inadequate strategy use. On a planning task, patients showed reduced planning times and suboptimal problem-solving. On an attentional set-shifting task, 75% of patients were able to perform an extra-dimensional shift thought to be a core attribute of prefrontal cortex function. Those who failed had significantly longer DUP.

Conclusions

Prefrontal cortex function deteriorates at the onset of psychosis and continues to worsen over time.

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Copyright

Corresponding author

Dr Eileen Joyce, Imperial College Faculty of Medicine, Charing Cross Site, St Dunstan's Road, London W6 8RP. e-mail: e.joyce@ic.ac.uk

Footnotes

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Presented in part at the European First Episode Schizophrenia Network Meeting, Whistler BC, Canada, 27 April 2001.

Declaration of interest

None. Funding from The Wellcome Trust.

Footnotes

References

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Executive dysfunction in first-episode schizophrenia and relationship to duration of untreated psychosis: The West London Study

  • Eileen Joyce (a1), Sam Hutton (a1), Stan Mutsatsa (a1), Heidi Gibbins (a1), Emma Webb (a1), Sonja Paul (a1), Trevor Robbins (a2) and Thomas Barnes (a1)...

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Executive dysfunction in first-episode schizophrenia and relationship to duration of untreated psychosis: The West London Study

  • Eileen Joyce (a1), Sam Hutton (a1), Stan Mutsatsa (a1), Heidi Gibbins (a1), Emma Webb (a1), Sonja Paul (a1), Trevor Robbins (a2) and Thomas Barnes (a1)...
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