Neuropsychological impairments in schizophrenia and psychotic Bipolar disorder

Findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study

S. Kristian Hill, James L. Reilly, Richard S E Keefe, James M. Gold, Jeffrey R. Bishop, Elliot S. Gershon, Carol A. Tamminga, Godfrey D. Pearlson, Matcheri S. Keshavan, John A. Sweeney

Research output: Contribution to journalArticle

160 Citations (Scopus)

Abstract

Objective: Familialneuropsychologicaldeficits are well established in schizophrenia but remain less well characterized in other psychotic disorders. This study from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium 1) compares cognitive impairment in schizophrenia and bipolar disorder with psychosis, 2) tests a continuum model of cognitive dysfunction in psychotic disorders, 3) reports familiality of cognitive impairments across psychotic disorders, and 4) evaluates cognitive impairment among nonpsychotic relatives with and without cluster A personality traits. Method: Participants included probands with schizophrenia (N=293), psychotic bipolar disorder (N=227), schizoaffective disorder (manic, N=110; depressed, N=55), their first-degree relatives (N=316, N=259, N=133, and N=64, respectively), and healthy comparison subjects (N=295). All participants completed the Brief Assessment of Cognition in Schizophrenia (BACS) neuropsychological battery. Results: Cognitive impairments among psychotic probands, compared to healthy comparison subjects, were progressively greater from bipolar disorder (z=-0.77) to schizoaffective disorder (manic z=-1.08; depressed z=-1.25) to schizophrenia (z=-1.42). Profiles across subtests of the BACS were similar across disorders. Familiality of deficits was significant and comparable in schizophrenia and bipolar disorder. Of particular interest were similar levels of neuropsychological deficits in relatives with elevated cluster A personality traits across proband diagnoses. Nonpsychotic relatives of schizophreniaprobands without these personality traits exhibited significant cognitive impairments, while relatives of bipolar probands did not. Conclusions: Robust cognitive deficits are present and familial in schizophrenia and psychotic bipolar disorder. Severity of cognitive impairments across psychotic disorders was consistent with a continuum model, in which more prominent affective features and less enduring psychosis were associated with less cognitive impairment. Cognitive dysfunction in firstdegree relatives is more closely related to psychosis-spectrum personality disorder traits in psychotic bipolar disorder than in schizophrenia.

Original languageEnglish (US)
Pages (from-to)1275-1284
Number of pages10
JournalAmerican Journal of Psychiatry
Volume170
Issue number11
DOIs
StatePublished - Nov 1 2013

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Bipolar Disorder
Psychotic Disorders
Schizophrenia
Phenotype
Personality
Cognition
Intermediate
Impairment
Healthy Volunteers
Cognitive Dysfunction
Cognitive Impairment
Personality Disorders

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Arts and Humanities (miscellaneous)

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Neuropsychological impairments in schizophrenia and psychotic Bipolar disorder : Findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study. / Kristian Hill, S.; Reilly, James L.; Keefe, Richard S E; Gold, James M.; Bishop, Jeffrey R.; Gershon, Elliot S.; Tamminga, Carol A.; Pearlson, Godfrey D.; Keshavan, Matcheri S.; Sweeney, John A.

In: American Journal of Psychiatry, Vol. 170, No. 11, 01.11.2013, p. 1275-1284.

Research output: Contribution to journalArticle

Kristian Hill, S. ; Reilly, James L. ; Keefe, Richard S E ; Gold, James M. ; Bishop, Jeffrey R. ; Gershon, Elliot S. ; Tamminga, Carol A. ; Pearlson, Godfrey D. ; Keshavan, Matcheri S. ; Sweeney, John A. / Neuropsychological impairments in schizophrenia and psychotic Bipolar disorder : Findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study. In: American Journal of Psychiatry. 2013 ; Vol. 170, No. 11. pp. 1275-1284.
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abstract = "Objective: Familialneuropsychologicaldeficits are well established in schizophrenia but remain less well characterized in other psychotic disorders. This study from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium 1) compares cognitive impairment in schizophrenia and bipolar disorder with psychosis, 2) tests a continuum model of cognitive dysfunction in psychotic disorders, 3) reports familiality of cognitive impairments across psychotic disorders, and 4) evaluates cognitive impairment among nonpsychotic relatives with and without cluster A personality traits. Method: Participants included probands with schizophrenia (N=293), psychotic bipolar disorder (N=227), schizoaffective disorder (manic, N=110; depressed, N=55), their first-degree relatives (N=316, N=259, N=133, and N=64, respectively), and healthy comparison subjects (N=295). All participants completed the Brief Assessment of Cognition in Schizophrenia (BACS) neuropsychological battery. Results: Cognitive impairments among psychotic probands, compared to healthy comparison subjects, were progressively greater from bipolar disorder (z=-0.77) to schizoaffective disorder (manic z=-1.08; depressed z=-1.25) to schizophrenia (z=-1.42). Profiles across subtests of the BACS were similar across disorders. Familiality of deficits was significant and comparable in schizophrenia and bipolar disorder. Of particular interest were similar levels of neuropsychological deficits in relatives with elevated cluster A personality traits across proband diagnoses. Nonpsychotic relatives of schizophreniaprobands without these personality traits exhibited significant cognitive impairments, while relatives of bipolar probands did not. Conclusions: Robust cognitive deficits are present and familial in schizophrenia and psychotic bipolar disorder. Severity of cognitive impairments across psychotic disorders was consistent with a continuum model, in which more prominent affective features and less enduring psychosis were associated with less cognitive impairment. Cognitive dysfunction in firstdegree relatives is more closely related to psychosis-spectrum personality disorder traits in psychotic bipolar disorder than in schizophrenia.",
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AU - Reilly, James L.

AU - Keefe, Richard S E

AU - Gold, James M.

AU - Bishop, Jeffrey R.

AU - Gershon, Elliot S.

AU - Tamminga, Carol A.

AU - Pearlson, Godfrey D.

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AU - Sweeney, John A.

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