Clinical and developmental characteristics of cognitive subgroups in a transdiagnostic sample of schizophrenia spcectrum disorders and bipolar disorder

© 2022 Elsevier B.V. and ECNPEvidence suggests that neurocognitive dysfunction is a transdiagnostic feature of individuals across the continuum between schizophrenia and bipolar disorder. However, there is significant heterogeneity of neuropsychological and social-cognitive abilities in schizophrenia, schizoaffective disorder, and bipolar disorder. The current study aimed to investigate the clinical and developmental characteristics of cognitive subgroups within the schizo-bipolar spectrum. 147 clinically stable patients with schizophrenia, schizoaffective or bipolar disorder were assessed using clinical rating scales for current psychotic and affective symptoms, and a comprehensive neuropsychological battery including measures of social cognition (Hinting and Reading the mind from the Eyes (RMET) task)). Developmental history and premorbid academic functioning were also evaluated. The study also included 36 healthy controls. Neurocognitive subgroups were investigated using latent class analysis (LCA). The optimal number of clusters was determined based on the Bayesian information criterion. A logistic regression analysis was conducted to investigate the predictors of membership to the globally impaired subgroup. LCA revealed two neurocognitive clusters including globally impaired (n = 89, 60.5%) and near-normal cognitive functioning (n = 58, 39.5%) subgroups. The near-normal cognitive functioning subgroup was not significantly different from healthy controls. The globally impaired subgroup had a higher score of developmental abnormalities (p<0.001), poorer premorbid academic functioning, mothers who were less educated and more severe disorganized speech (p = 0.001) and negative symptoms (p = 0.004) compared to the near-normal cognitive functioning group. History of developmental abnormalities and persistent disorganization rather than diagnosis are significant predictors of the subgroup of individuals with global cognitive impairment in the schizophrenia-bipolar disorder continuum

Executive functions and impulsivity in suicide attempter adolescents with major depressive disorder

OBJECTIVE: The aim of this study was to examine the relationship between executive functions and suicidality in terms of impulsivity and depression severity. METHODS: Depressed adolescents who have made a suicide attempt in the last year (n = 32), depressed adolescents without a suicide attempt (n = 30), and healthy controls (n = 30) participated in the study in Dokuz Eylul University Faculty of Medicine, Department of Child and Adolescent Psychiatry. Clinical diagnoses were made according to the DSM-IV by applying Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL). Data were collected by using a sociodemographic data form, the Beck Depression Inventory (BDI), Barratt Impulsiveness Scale, and the Children’s Depression Rating Scale – Revised (CDRS-R). To evaluate all participants’ intelligence scores, the Wechsler Intelligence Scale for Children (WISC-R) was applied for adolescents aged under 16 years, and the Wechsler Adult Intelligence Scale (WAIS) was applied to adolescents aged 16–18 years. To determine the performance-based executive functions, Wisconsin Card Sorting Test and Stroop Test were applied to all participants. RESULTS: In this study, the participants who had made a suicide attempt displayed lower performance in the Stroop Test, especially in part 1 and part 4 compared with the controls (p = .04 and p = .011). Depressive patients also exhibited lower performance in the Stroop Test in part 3 compared with the controls (p = .049). Impulsivity was found more severe in depressive patients compared with controls (p < .001). There were no statistically significant differences between depressive patients with or without suicide attempt in terms of depression severity. CONCLUSION: Executive dysfunction appears to be associated with suicidal behaviour in adolescents with the major depressive disorder. This findings need to be replicated with a larger sample size in the future