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Schizophrenia and Intellect

Schizophrenia and Intellect. Thomas W. Weickert, Terry E. Goldberg, James M. Gold, Llewellen B. Bigelow, Michael F. Egan, Daniel R. Weinberger. Presentation by: Bryan Lang Caroline Helfrich and Jessica Wright.

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Schizophrenia and Intellect

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  1. Schizophrenia and Intellect Thomas W. Weickert, Terry E. Goldberg, James M. Gold, Llewellen B. Bigelow, Michael F. Egan, Daniel R. Weinberger Presentation by: Bryan Lang Caroline Helfrichand Jessica Wright Weickert, T. W., Goldberg, T. E., Gold, J. M., Bigelow, L. B., Egan, M. F., & Weinberger, D. R. (2000). Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Archives of General Psychiatry, 9(57), 907-913.

  2. Hypothesis That a group of intellectually declining patients would display executive function, attention, and memory deficits; and a group with premorbid and morbid IQ deficits would display a broader spectrum of cognitive impairment. Weickert, T. W., Goldberg, T. E., Gold, J. M., Bigelow, L. B., Egan, M. F., & Weinberger, D. R. (2000). Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Archives of General Psychiatry, 9(57), 907-913.

  3. Background • Although intellectual and neurocognitive deficits accompany schizophrenia, there are inconsistencies in the literature concerning issue of intellectual decline, premorbid deficits, a modal deficit pattern, and preserved abilities Weickert, T. W., Goldberg, T. E., Gold, J. M., Bigelow, L. B., Egan, M. F., & Weinberger, D. R. (2000). Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Archives of General Psychiatry, 9(57), 907-913.

  4. Methods • Neuropsychological tests were administered to 117 patients with chronic schizophrenia and a group of 27 healthy control subjects to examine patterns of premorbid and current intellect • Healthy control subjects were the comparison group to establish the degree to which schizophrenia patients deviate from normal ones on cognitive levels Weickert, T. W., Goldberg, T. E., Gold, J. M., Bigelow, L. B., Egan, M. F., & Weinberger, D. R. (2000). Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Archives of General Psychiatry, 9(57), 907-913.

  5. Results • 60 patients with schizophrenia who displayed a general intellectual decline of 10 points or greater from estimated premorbid levels also exhibited deficits of executive function, memory, and attention • 28 patients with schizophrenia with consistently low estimated premorbid intellect and current intellectual levels who displayed no evidence of IQ decline exhibited language and visual processing deficits in addition to deficits present in the intellectually declining group • The remaining 29 patients who displayed average estimated premorbid intellectual levels did not show a decline in IQ and exhibited a relatively normal cognitive profile, with the exception of executive function and attention impairment Weickert, T. W., Goldberg, T. E., Gold, J. M., Bigelow, L. B., Egan, M. F., & Weinberger, D. R. (2000). Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Archives of General Psychiatry, 9(57), 907-913.

  6. Conclusions • These results suggest that IQ decline, although modal in schizophrenia, is not universally characteristic and that executive function and attention deficits may be core features of schizophrenia, independent of IQ variations • A large minority of patients (25%) were intellectually intact Weickert, T. W., Goldberg, T. E., Gold, J. M., Bigelow, L. B., Egan, M. F., & Weinberger, D. R. (2000). Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Archives of General Psychiatry, 9(57), 907-913.

  7. Critical Review Items: 3 Interesting Points • 1. It was interesting to see that no matter what intellectual group the participants were put into, all of the schizophrenic participants had some type of executive function or attention deficit. These deficits were independent from the IQ variations and could be a possible insight into the central characteristics of schizophrenia. • 2. Even though there was an unexpected large minority of participants that showed to be intellectually intact, interesting conclusions were still drawn from them. First, the authors of the study were able to prove further that antipsychotic drugs don’t always have an effect on performance on cognitive tests. They also showed that individuals diagnosed with chronic schizophrenia can be cognitively unaffected in all areas other than executive functioning and attention. • 3. Overall, we believe that the authors of this study did a thorough job testing the cognitive abilities of the participants. The participants were tested on their memory, verbal retrieval, lexical integrity, attention, executive functioning, set shifting, perceptual abilities, psychomotor speed and motor speed. After seeing all of the results of the tests, it is safe to say that this study gave us a better understanding of schizophrenia and cognitive decline. Weickert, T. W., Goldberg, T. E., Gold, J. M., Bigelow, L. B., Egan, M. F., & Weinberger, D. R. (2000). Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Archives of General Psychiatry, 9(57), 907-913.

  8. Critical Review Items: 3 Weak/Unclear Points • 1. Because this study only included tests done on the participants after the onset of schizophrenia, we find it hard to understand how you can directly compare the results to previous IQ estimates done on the participants. We think the study would have been stronger if it was a longitudinal and had IQ scores from both before and after the onset of the disorder. • 2. Similar to the point above, it would have been interesting to see a longitudinal study of the participants to better understand the cognitive and intellectual deficits over time. All this study proves is that there are cognitive and intellectual deficits, but not when the onset of the deficits occurred. Knowing when and how the deficits occur would be much more beneficial to know when regarding treatment of the disorder. • 3. The last thing that we would alter in this study is how the researchers tested the participants. Because there are so many extensive tests done all in one session, we believe that the possibility of the participants being overwhelmed or drained would negatively affect test scores. Having the tests conducted over a couple of different sessions would help eliminate this problem. Weickert, T. W., Goldberg, T. E., Gold, J. M., Bigelow, L. B., Egan, M. F., & Weinberger, D. R. (2000). Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Archives of General Psychiatry, 9(57), 907-913.

  9. Video: Jani Loses Touch With Reality (example of short attention span) • http://www.youtube.com/watch?v=WjqRYgICgdU Weickert, T. W., Goldberg, T. E., Gold, J. M., Bigelow, L. B., Egan, M. F., & Weinberger, D. R. (2000). Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Archives of General Psychiatry, 9(57), 907-913.

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