Cognitive and social cognitive impairments: A 4-year follow-up study

Neurocognitive disorders in schizophrenia have become the center of interest since the era that the disease has been preliminarily described till today and have been studied more than a century. Although it has been frequently shown that the performance of schizophrenia patients on neurocognitive tests are lower than controls, these disorders still did not take any place in diagnostic and treatment processes contemporarily. Therefore it is still studied vigorously. One of the study topics in this domain is the relation of neurocognitive disorders with clinical symptoms of schizophrenia. The studies on this topic report inconsistent conclusions and it has been emphasized that the reason of these discrepancies may be the most common utilization of three-factor model of the Positive and Negative Syndrome Scale (PANSS), which is the typical instrument used to evaluate clinical symptoms of schizophrenia. The number of studies that have been conducted with five-factor model of PANSS increase especially in recent years. The purpose of this study is to investigate neurocognitive disorders of schizophrenia patients in a multifaceted manner, both cross-sectional and longitudinally; also to reveal the relation between neurocognitive disorders and clinical symptoms especially in longitudinal course by utilizing five-factor model of PANSS. For this purpose, 135 schizophrenia patients who came to Dokuz Eylül University Medical Faculty Psychiatry Department Schizophrenia and Other Psychotic Disorders Outpatient Clinic and 51 controls from the field were included into the study; out of 135 patients 50 of them were included into the follow-up study which have a mean of five years. All paticipants took neurocognitive tests, patients were also evaluated with PANSS and social cognitive test. Cross-sectional findings indicate that in compliance with the controls, patients have lower performances on tests of memory, executive functions, attention, language abilities; patients in remission have similar performances with controls regarding auditory attention and short-term retention abilities. Longitudinally, it was revealed that patients' neurocognitive and social cognitive disorders remained stable. Also the patients', who were in remission in both first and follow-up evaluations, processing speed and attention abilities improved over time; where the patients', who were not in remission in both evaluations, processing speed and attention abilities worsened over time. Utilizing five-factor model of PANSS, within five years, patients' worsening on positive, negative, emotional distress factors were related to the patients' executive functions deterioration. In this study it is concluded that, neurocognitive disorders in schizophrenia have a relation with remission state and clinical symptoms; also it is highlighted that neurocognitive disorders should have take place in diagnostic and treatment processes.