Executive function performance as neurocognitive differentiating marker between schizophrenia and psychotic depression

Background and aimSchizophrenia and psychotic depression are two psychiatric disorders sharing in common the presence of psychotic features, delusion, hallucinations or both and severe impairment in occupational functions. Added to that the diagnostic dilemma to differentiate between severe psychomotor retardation, which is not uncommon in psychotic depression, and negative symptoms of schizophrenia. Our work aims at utilizing Wisconsin Card Sorting Test WCST performance as a differentiating diagnostic tool helping in differentiating between both diagnosis.Subjects and methodsPatients are recruited randomly from the outpatient service of Alexandria University Hospitals, three groups are included;Group I patients with psychotic depression,Group II schizophrenic patients andGroup III control group.Patients recruited in both group I and II score 4 or higher on the Clinical Global Impression for Severity CGI-S scale, all participants were subjected to Brief Psychiatric Rating scale and Wisconsin Card Sorting Test WCST 128 card computerized version.ResultsThe study showed severe impairment in executive functions in all parameters assessed by the WCST including number of administered trials, percentage of errors and perseverative errors as well as failure to maintain categories. Such cognitive dysfunction was significantly more severe in schizophrenia than both other groups. Both schizophrenic and psychotically depressed groups showed poorer performance compared to healthy control.ConclusionPerformance on WCST may be of great help as a differentiating diagnostic tool to distinguish between schizophrenia and psychotic depression.

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INECO Frontal Screening: an Instrument to assess Executive Dysfunction in Schizophrenia

The Spanish Journal of Psychology ◽

10.1017/sjp.2014.22 ◽

2014 ◽

Vol 17 ◽

Cited By ~ 4

Author(s):

Tânia Silva ◽

Luís Monteiro ◽

Emanuela Lopes

Keyword(s):

Executive Dysfunction ◽

Wisconsin Card Sorting Test ◽

Screening Tools ◽

Control Group ◽

Healthy Controls ◽

Card Sorting ◽

Schizophrenic Patients ◽

Wisconsin Card Sorting ◽

Sorting Test ◽

Experimental Group

AbstractAlthough several brief sensitive screening tools are available to detect executive dysfunction, few have been developed to quickly assess executive functioning. The INECO Frontal Screening (IFS) is a brief tool which has proved be useful for the assessment of the executive functions in patients with dementia. The aim of this study was to explore whether the IFS is as sensitive and specific as the BADS, a battery designed to assess the dysexecutive syndrome, in schizophrenia. Our sample comprised a group of 34 schizophrenic patients (Mean age = 39.59, DP = 10.697) and 31 healthy controls (Mean age = 35.52, DP = 10.211). To all groups were administered the BADS, Wisconsin Card Sorting Test and IFS. The results suggest that schizophrenic patients performed significantly worse than the control group in all tests (p < .05). The IFS total score was 13.29 for the experimental group and 26.21 for the control group (p < .001). Considering a cut-off of 14 points, the IFS sensitivity was 100% and specificity 56% in detection of executive dysfunction in schizophrenia, compared with the BADS, that if we consider a cut-off of 11 points, was a sensitivity of 100% and a specificity of 50%. Thus, IFS is a brief, sensitive and specific tool for the detection of executive dysfunction in schizophrenia.

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Cognitive Inflexibility and Pre-frontal Dysfunction in Schizophrenia and Mania

The British Journal of Psychiatry ◽

10.1192/bjp.157.1.50 ◽

1990 ◽

Vol 157 (1) ◽

pp. 50-54 ◽

Cited By ~ 178

Author(s):

Rodney Morice

Keyword(s):

Cognitive Assessment ◽

Poor Performance ◽

Wisconsin Card Sorting Test ◽

Control Group ◽

Card Sorting ◽

Frontal Dysfunction ◽

Cognitive Inflexibility ◽

Wisconsin Card Sorting ◽

Sorting Test ◽

And Control

The ability to shift cognitive set, which is probably subserved, at least in part, by the pre-frontal cortex, was determined for schizophrenic, bipolar (manic) and control subjects, using the Wisconsin Card Sorting Test (WCST). The schizophrenic and manic subjects both demonstrated poor performance on the WCST, suggesting that cognitive inflexibility and/or pre-frontal dysfunction, is not specific to schizophrenia (although laterality differences could exist). Moderate levels of poor performance in the non-psychiatric control group suggest the need for a review of the cut-off figures in the WCST currently used for predicting ‘brain damage’ and ‘focal frontal involvement‘, especially given the trend for the increasing use of cognitive assessment and rehabilitation in the major psychoses.

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WCST Performance in Schizophrenia and Severe Depression with Psychotic Features

ISRN Psychiatry ◽

10.5402/2012/373748 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Ahmed Rady ◽

Adel Elsheshai ◽

Heba Abou el Wafa ◽

Osama Elkholy

Keyword(s):

Outpatient Service ◽

Severe Depression ◽

Wisconsin Card Sorting Test ◽

University Hospital ◽

Psychotic Depression ◽

Card Sorting ◽

Significant Difference ◽

Wisconsin Card Sorting ◽

Psychotic Features ◽

Sorting Test

Background. Differentiating between schizophrenia and major depression with psychotic features often reveals diagnostic dilemma. Both share psychotic features and severe impairment in occupational functions. Severe psychomotor retardation, not uncommon in psychotic depression, may simulate negative symptoms of schizophrenia. Our work aims at utilizing Wisconsin Card Sorting Test (WCST) performance as a potential differentiating neurocognitive tool. Subjects and Methods. 60 patients were recruited randomly from the outpatient service at Alexandria University Hospital: 30 patients with schizophrenia and 30 patients with chronic psychotic depression. They were subjected to Clinical Global Impression for Severity (CGI-S) scale and Wisconsin Card Sorting Test (WCST) 128 card computerized version. Results. Both groups were balanced in terms of gender distribution, severity and duration of illness. The study compared all parameters of WCST. Only perseverative errors showed mild significant difference () that disappeared when applying Bonferroni adaptation, setting significance level at 0.01 instead of 0.05. Conclusion. Performance on WCST is similar in schizophrenia and severe depression with psychotic features in most of the measured parameters and hence could not serve as a supplementary tool differentiating between both diagnoses in our study.

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Neurocognitive recovery of patients with paranoid schizophrenia

Psychosomatic Medicine and General Practice ◽

10.26766/pmgp.v2i4.92 ◽

2017 ◽

Vol 2 (4) ◽

pp. e020492

Author(s):

Olena Molchanova

Keyword(s):

Cognitive Impairment ◽

Paranoid Schizophrenia ◽

Intervention Group ◽

Wisconsin Card Sorting Test ◽

Disease Stage ◽

Control Group ◽

Card Sorting ◽

Significant Difference ◽

Wisconsin Card Sorting ◽

Sorting Test

Background At present neurocognitive impairment is considered a core feature of schizophrenia. This statement is grounded on cognitive impairment stability, the persistence of cognitive impairment independently of the disease stage and other symptoms of schizophrenia. The relevance of the search for cognitive remediation methods is determined by the influence of cognitive functioning on the functional outcome in patients with schizophrenia. In order to solve this problem, scientists are actively investigating such direction in the treatment of patients with this psychopathology as «neurocognitive therapy» or neurocognitive training. Objective To evaluate the effectiveness of neurocognitive training in patients with paranoid schizophrenia Methods and materials The patients who matched inclusion criteria were assessed on Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance scale (PSP), neuropsychological tests (Trail Making Test part A and B, Wisconsin Card Sorting Test, Luria test) at the baseline, 1st and 6th month. All patients who were included in the study were randomly assigned into two groups. The intervention group (n=40) underwent a standard supportive treatment and neurocognitive training. The control group (n=31) received supportive medication treatment alone. Results After 1st month, a statistically significant difference between the intervention and control groups was found both for the overall PANSS score improvement and improvement in several items, which represented the cognitive decline. Total PSP score increased significantly in the intervention group from 41-50 to 51-60 (р=0.0001). In Wisconsin Card Sorting Test the proportion of incorrect answers decreased by 31.4% (р=0.0001), perseverative errors by 20.1% (р=0.042), the number of completed categories increased by 33.5% (р=0.002). Conclusion The proposed neurocognitive training program showed positive results, which was reflected in a statistically significant improvement in PANSS score and cognitive tests performance in the intervention group compared to control group after treatment course and additional 5 months of the observation.

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Diagnostic Utility of the Shortened Version of the Wisconsin Card Sorting Test in Patients With Sporadic Late Onset Alzheimer Disease

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317517728334 ◽

2017 ◽

Vol 32 (8) ◽

pp. 472-478 ◽

Cited By ~ 2

Author(s):

Juan Luis Sánchez ◽

Javier Martín ◽

Carolina López

Keyword(s):

Alzheimer Disease ◽

Late Onset ◽

Wisconsin Card Sorting Test ◽

Clinical Usefulness ◽

Control Group ◽

Diagnostic Utility ◽

Negative Consequences ◽

Card Sorting ◽

Wisconsin Card Sorting ◽

Sorting Test

Background: The classic version of the Wisconsin Card Sorting Test (WCST) consists of correctly sorting 128 cards according to changing sorting criteria. Its application is costly in terms of the time employed, with all the negative consequences this entails (decrease in motivation, frustration, and fatigue). Method: The main objective of this study was to test the usefulness of the shortened version of the WCST as compared to the full test by analyzing the equivalence between the two decks comprising the full 128-card version on a sample of patients diagnosed with sporadic late onset Alzheimer disease (SLOAD) and to check its clinical usefulness. Results: The variables showed equivalence between the two decks and their ability to differentiate between the control group (CG) and the Alzheimer disease (AD) group. Conclusion: The scores obtained suggest equivalence between decks and that the application of only the first deck is sufficient.

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The relationship between cognitive function and clinical and functional outcomes in major depressive disorder

Psychological Medicine ◽

10.1017/s0033291708003620 ◽

2008 ◽

Vol 39 (3) ◽

pp. 393-402 ◽

Cited By ~ 54

Author(s):

A. Withall ◽

L. M. Harris ◽

S. R. Cumming

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Rating Scale ◽

Wisconsin Card Sorting Test ◽

Card Sorting ◽

Major Depressive ◽

Perseverative Errors ◽

Wisconsin Card Sorting ◽

Sorting Test

BackgroundAlthough cognitive variables have been shown to be useful in predicting outcomes in late-life depression, there has not yet been a comprehensive study in younger persons with depression.MethodThe clinical symptoms and cognitive performance of participants were evaluated at admission to one of two university teaching hospitals and again at 3 months after remission and discharge. A total of 52 participants with a DSM-IV diagnosis of major depressive disorder, aged between 20 and 60 years and with a Hamilton Depression Rating Scale score ⩾17 entered the study. The sample for this paper comprises the 48 subjects (mean age 37.9 years, s.d.=10.7) who received admission and follow-up assessments; an attrition rate of 7.7%.ResultsMore perseverative errors on the shortened Wisconsin Card Sorting Test at admission predicted a worse clinical outcome at follow-up. Poor event-based prospective memory and more perseverative errors on the shortened Wisconsin Card Sorting Test at admission predicted worse social and occupational outcome at follow-up.ConclusionsThese results suggest that a brief cognitive screen at hospital admission, focusing on executive function, would have a useful prognostic value in depression. Determining early predictors of individuals at risk of poorer outcomes is important for identifying those who may need altered or additional treatment approaches.

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The Role of Shifting, Inhibition and Working Memory in Older Adults' Performance in the Wisconsin Card Sorting Test

PsycEXTRA Dataset ◽

10.1037/e512682013-588 ◽

2007 ◽

Author(s):

Nadia Gamboz ◽

Erika Borella ◽

Maria Antonella Brandimonte

Keyword(s):

Older Adults ◽

Working Memory ◽

Wisconsin Card Sorting Test ◽

Card Sorting ◽

Wisconsin Card Sorting ◽

Sorting Test

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Dopaminergic Genes Polymorphisms and Prefrontal Cortex Efficiency Among Obese People - Whether Gender is a Differentiating Factor?

Current Molecular Medicine ◽

10.2174/1566524019666190424143653 ◽

2019 ◽

Vol 19 (6) ◽

pp. 405-418

Author(s):

Maciej Bieliński ◽

Natalia Lesiewska ◽

Roman Junik ◽

Anna Kamińska ◽

Andrzej Tretyn ◽

...

Keyword(s):

Prefrontal Cortex ◽

Executive Functions ◽

Tandem Repeats ◽

Wisconsin Card Sorting Test ◽

Variable Number ◽

Card Sorting ◽

Obese People ◽

Perseverative Errors ◽

Wisconsin Card Sorting ◽

Sorting Test

Background:Obesity is a chronic condition associated with poorer cognitive functioning. Wisconsin Card Sorting Test (WCST) is a useful tool for evaluating executive functions. In this study, we assessed the association between dopaminergic gene polymorphisms: DAT1 (SLC6A3), COMTVal158Met, DRD4 (48-bp variable number of tandem repeats - VNTR) and WCST parameters to investigate the functions of the frontal lobes in obese individuals.Objective:To find the significant correlations between polymorphisms of DAT1, COMTVal158Met, DRD4 and executive functions in obese subjects.Methods:The analysis of the frequency of individual alleles was performed in 248 obese patients (179 women, 69 men). Evaluation of the prefrontal cortex function (operating memory and executive functions) was measured with the Wisconsin Card Sorting Test (WCST). Separate analyzes were performed in age subgroups to determine different activities and regulation of genes in younger and older participants.Results:Scores of WCST parameters were different in the subgroups of women and men and in the age subgroups. Regarding the COMT gene, patients with A/A and G/A polymorphisms showed significantly better WCST results in WCST_P, WCST_CC and WCST_1st. Regarding DAT1 men with L/L and L/S made less non-perseverative errors, which was statistically significant. In DRD4, significantly better WCST_1st results were found only in older women with S allele.Conclusion:Obtained results indicate the involvement of dopaminergic transmission in the regulation of prefrontal cortex function. Data analysis indicates that prefrontal cortex function may ensue, from different elements such as genetic factors, metabolic aspects of obesity, and hormonal activity (estrogen).

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