Neuropsychological function and dysfunction in schizophrenia and affective disorders

Background: Mounting evidence suggests that compro-mised neurocognitive function is a central feature of schizophrenia. There are, however, schizophrenia patients with a normal neuropsychological (NP) performance, but estimates of the proportion of NP normal patients vary considerably between studies. Neurocognitive dysfunction is also a characteristic of other psychotic disorders, yet there are inconsistencies in the literature regarding the sim-ilarity to impairments in schizophrenia. NP normality in psychotic affective disorders has not been systematically studied. Methods: Data came from the Suffolk County Mental Health Project, an epidemiological study of first-admission patients with psychotic disorders. Respond-ents with a diagnosis of schizophrenia (N = 94) or schizo-affective disorder (N = 15), bipolar disorder (N = 78), and major depressive disorder (N = 48) were administered a-battery of NP tests assessing 8 cognitive domains 2 years after index admission. Patients ’ performance profile was compared, and their NP status was classified based on 3 previously published criteria that vary in their stringency. Results: The 4 diagnostic groups had comparable NP performance profile patterns. All groups demonstrated impairments in memory, executive functions, and attention and processing speed. However, schizophrenia patients were more impaired than the other groups on all cognitive domains. Results were not attenuated when IQ was con-trolled. Prevalence of NP normality ranged betwee