The relationship of neuropsychological test performance with the PANSS in antipsychotic naïve, first-episode psychosis patients

Kimberley P. Good; Jonathan Rabinowitz; David Whitehorn; Philip D. Harvey; Goedele DeSmedt; Lili C. Kopala

doi:10.1016/j.schres.2003.07.001

The relationship of neuropsychological test performance with the PANSS in antipsychotic naïve, first-episode psychosis patients

Kimberley P. Good
, Jonathan Rabinowitz
, David Whitehorn
, Philip D. Harvey
, Goedele DeSmedt
, Lili C. Kopala

The Louis & Gabi Weisfeld School of Social Work

Dalhousie University
Icahn School of Medicine at Mount Sinai
Johnson & Johnson
University of British Columbia

Research output: Contribution to journal › Article › peer-review

64 Scopus citations

Abstract

Background: Chronic schizophrenia patients have been sampled for factor analytic studies to identify the factor structure of the Positive and Negative Syndrome Scale (PANSS). Many of these studies have identified a cognitive factor, which may provide useful information about patients for whom formal neuropsychological testing is unavailable. However, the relationship between the clinically rated cognitive factor and performance-based cognitive test scores has not been thoroughly examined, particularly in patients who are early in the course of illness. Objectives: The validity of the PANSS cognitive factor was examined in a sample of antipsychotic naïve, first-episode psychosis patients and the PANSS items that best predicted cognitive functioning were identified. Method: PANSS scores and performance on a battery of cognitive tests from the baseline assessment of a clinical trial of 167 neuroleptic naïve patients with schizophrenia-like illnesses were analyzed. Results: Factor analysis revealed a five-factor model that was consistent with previously described factor models from samples of chronically treated patients. There were modest correlations (less than r=0.44) between the derived cognitive factor and six of the neuropsychological test variables (Wisconsin Card Sorting Test total errors and number of categories correctly sorted, WMS-R immediate and delayed recall scores, Category Fluency total score, and WAIS-R digit symbol). Five PANSS items (P6, N5, N6, G2, and G10) were identified that predicted global cognitive functioning; however, 66% of the variance in cognitive functioning remained unexplained. Conclusions: A PANSS cognitive factor can be identified in first-episode, neuroleptic naïve patients. However, clinical ratings of cognitive deficits lack sensitivity and specificity and thus should not be relied upon fully.

Original language	English
Pages (from-to)	11-19
Number of pages	9
Journal	Schizophrenia Research
Volume	68
Issue number	1
DOIs	https://doi.org/10.1016/j.schres.2003.07.001
State	Published - 1 May 2004

Bibliographical note

Funding Information:
This international, multi-site study was funded by Janssen Research Foundation. The authors wish to acknowledge the assistance of the many clinicians who provided PANSS ratings and the psychometrists who performed the cognitive testing. Dr. Kim Good was granted a Young Investigator Award from the National Alliance for Research on Schizophrenia and Depression and holds a Clinical Research Scholar Award from Dalhousie Medical School. Infrastructure support was partially provided by the Department of Health, Province of Nova Scotia. The study included the following investigators and locations: Australia: P. McGorry (Melbourne); T. Lambert (Bentley); J. Kulkarni (Dandenong); Austria: W. Fleischhacker (Innsbruck); Canada: D. Addington (Calgary); L. Kopala (Halifax); R. Williams (Calgary); G. Chouinard (Montreal); A. Labelle (Ottawa); A. Malla (London); S. Purdon (Edmonton); M. Saxena (Hamilton); V. Nair (Montreal); R. Matte (Sherbrooke); S. Johnson (St. John's); L. Beauclair (Montreal); Finland: K. Lehtinen (Tampere); France: E.R. Lombertie (Limoges); J-A. Meynard (La Rochelle); Germany: H. Freyberger (Stralsund); H-J. Möller (Munich); Israel: M. Davidson (Ramat-Gan); A. Elitzur (Bat-Yam); M. Kotler (Be'er Sheva); I. Treves (Hod-Hasharon); A. Weizman (Petach-Tikva); Netherlands: P. Dries (Poortugaal); New Zealand: D. Codyre (Auckland); South Africa: R. Emsley (Cape Town); C. Gagiano (Bloemfontein); United Kingdom: M. Reveley (Leicester); T. Sharma (London); United States of America: J. Csernansky (St. Louis); L. DeLisi (Stony Brook); J. Lauriello (Albuquerque); T. Manschreck (Fall River); J. Pahl (Oklahoma City); N. Schooler (Pittsburgh); S. Schulz (Cleveland); S. Targum (Philadelphia); S. Risch (Charleston).

Funding

This international, multi-site study was funded by Janssen Research Foundation. The authors wish to acknowledge the assistance of the many clinicians who provided PANSS ratings and the psychometrists who performed the cognitive testing. Dr. Kim Good was granted a Young Investigator Award from the National Alliance for Research on Schizophrenia and Depression and holds a Clinical Research Scholar Award from Dalhousie Medical School. Infrastructure support was partially provided by the Department of Health, Province of Nova Scotia. The study included the following investigators and locations: Australia: P. McGorry (Melbourne); T. Lambert (Bentley); J. Kulkarni (Dandenong); Austria: W. Fleischhacker (Innsbruck); Canada: D. Addington (Calgary); L. Kopala (Halifax); R. Williams (Calgary); G. Chouinard (Montreal); A. Labelle (Ottawa); A. Malla (London); S. Purdon (Edmonton); M. Saxena (Hamilton); V. Nair (Montreal); R. Matte (Sherbrooke); S. Johnson (St. John's); L. Beauclair (Montreal); Finland: K. Lehtinen (Tampere); France: E.R. Lombertie (Limoges); J-A. Meynard (La Rochelle); Germany: H. Freyberger (Stralsund); H-J. Möller (Munich); Israel: M. Davidson (Ramat-Gan); A. Elitzur (Bat-Yam); M. Kotler (Be'er Sheva); I. Treves (Hod-Hasharon); A. Weizman (Petach-Tikva); Netherlands: P. Dries (Poortugaal); New Zealand: D. Codyre (Auckland); South Africa: R. Emsley (Cape Town); C. Gagiano (Bloemfontein); United Kingdom: M. Reveley (Leicester); T. Sharma (London); United States of America: J. Csernansky (St. Louis); L. DeLisi (Stony Brook); J. Lauriello (Albuquerque); T. Manschreck (Fall River); J. Pahl (Oklahoma City); N. Schooler (Pittsburgh); S. Schulz (Cleveland); S. Targum (Philadelphia); S. Risch (Charleston).

Funders
Department of Health, Province of Nova Scotia
Janssen Research Foundation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

First-episode psychosis
Neuropsychological test performance
PANSS

Access to Document

10.1016/j.schres.2003.07.001

Cite this

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title = "The relationship of neuropsychological test performance with the PANSS in antipsychotic na{\"i}ve, first-episode psychosis patients",

abstract = "Background: Chronic schizophrenia patients have been sampled for factor analytic studies to identify the factor structure of the Positive and Negative Syndrome Scale (PANSS). Many of these studies have identified a cognitive factor, which may provide useful information about patients for whom formal neuropsychological testing is unavailable. However, the relationship between the clinically rated cognitive factor and performance-based cognitive test scores has not been thoroughly examined, particularly in patients who are early in the course of illness. Objectives: The validity of the PANSS cognitive factor was examined in a sample of antipsychotic na{\"i}ve, first-episode psychosis patients and the PANSS items that best predicted cognitive functioning were identified. Method: PANSS scores and performance on a battery of cognitive tests from the baseline assessment of a clinical trial of 167 neuroleptic na{\"i}ve patients with schizophrenia-like illnesses were analyzed. Results: Factor analysis revealed a five-factor model that was consistent with previously described factor models from samples of chronically treated patients. There were modest correlations (less than r=0.44) between the derived cognitive factor and six of the neuropsychological test variables (Wisconsin Card Sorting Test total errors and number of categories correctly sorted, WMS-R immediate and delayed recall scores, Category Fluency total score, and WAIS-R digit symbol). Five PANSS items (P6, N5, N6, G2, and G10) were identified that predicted global cognitive functioning; however, 66\% of the variance in cognitive functioning remained unexplained. Conclusions: A PANSS cognitive factor can be identified in first-episode, neuroleptic na{\"i}ve patients. However, clinical ratings of cognitive deficits lack sensitivity and specificity and thus should not be relied upon fully.",

keywords = "First-episode psychosis, Neuropsychological test performance, PANSS",

author = "Good, \{Kimberley P.\} and Jonathan Rabinowitz and David Whitehorn and Harvey, \{Philip D.\} and Goedele DeSmedt and Kopala, \{Lili C.\}",

note = "Funding Information: This international, multi-site study was funded by Janssen Research Foundation. The authors wish to acknowledge the assistance of the many clinicians who provided PANSS ratings and the psychometrists who performed the cognitive testing. Dr. Kim Good was granted a Young Investigator Award from the National Alliance for Research on Schizophrenia and Depression and holds a Clinical Research Scholar Award from Dalhousie Medical School. Infrastructure support was partially provided by the Department of Health, Province of Nova Scotia. The study included the following investigators and locations: Australia: P. McGorry (Melbourne); T. Lambert (Bentley); J. Kulkarni (Dandenong); Austria: W. Fleischhacker (Innsbruck); Canada: D. Addington (Calgary); L. Kopala (Halifax); R. Williams (Calgary); G. Chouinard (Montreal); A. Labelle (Ottawa); A. Malla (London); S. Purdon (Edmonton); M. Saxena (Hamilton); V. Nair (Montreal); R. Matte (Sherbrooke); S. Johnson (St. John's); L. Beauclair (Montreal); Finland: K. Lehtinen (Tampere); France: E.R. Lombertie (Limoges); J-A. Meynard (La Rochelle); Germany: H. Freyberger (Stralsund); H-J. M{\"o}ller (Munich); Israel: M. Davidson (Ramat-Gan); A. Elitzur (Bat-Yam); M. Kotler (Be'er Sheva); I. Treves (Hod-Hasharon); A. Weizman (Petach-Tikva); Netherlands: P. Dries (Poortugaal); New Zealand: D. Codyre (Auckland); South Africa: R. Emsley (Cape Town); C. Gagiano (Bloemfontein); United Kingdom: M. Reveley (Leicester); T. Sharma (London); United States of America: J. Csernansky (St. Louis); L. DeLisi (Stony Brook); J. Lauriello (Albuquerque); T. Manschreck (Fall River); J. Pahl (Oklahoma City); N. Schooler (Pittsburgh); S. Schulz (Cleveland); S. Targum (Philadelphia); S. Risch (Charleston).",

year = "2004",

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doi = "10.1016/j.schres.2003.07.001",

language = "אנגלית",

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T1 - The relationship of neuropsychological test performance with the PANSS in antipsychotic naïve, first-episode psychosis patients

AU - Good, Kimberley P.

AU - Rabinowitz, Jonathan

AU - Whitehorn, David

AU - Harvey, Philip D.

AU - DeSmedt, Goedele

AU - Kopala, Lili C.

N1 - Funding Information: This international, multi-site study was funded by Janssen Research Foundation. The authors wish to acknowledge the assistance of the many clinicians who provided PANSS ratings and the psychometrists who performed the cognitive testing. Dr. Kim Good was granted a Young Investigator Award from the National Alliance for Research on Schizophrenia and Depression and holds a Clinical Research Scholar Award from Dalhousie Medical School. Infrastructure support was partially provided by the Department of Health, Province of Nova Scotia. The study included the following investigators and locations: Australia: P. McGorry (Melbourne); T. Lambert (Bentley); J. Kulkarni (Dandenong); Austria: W. Fleischhacker (Innsbruck); Canada: D. Addington (Calgary); L. Kopala (Halifax); R. Williams (Calgary); G. Chouinard (Montreal); A. Labelle (Ottawa); A. Malla (London); S. Purdon (Edmonton); M. Saxena (Hamilton); V. Nair (Montreal); R. Matte (Sherbrooke); S. Johnson (St. John's); L. Beauclair (Montreal); Finland: K. Lehtinen (Tampere); France: E.R. Lombertie (Limoges); J-A. Meynard (La Rochelle); Germany: H. Freyberger (Stralsund); H-J. Möller (Munich); Israel: M. Davidson (Ramat-Gan); A. Elitzur (Bat-Yam); M. Kotler (Be'er Sheva); I. Treves (Hod-Hasharon); A. Weizman (Petach-Tikva); Netherlands: P. Dries (Poortugaal); New Zealand: D. Codyre (Auckland); South Africa: R. Emsley (Cape Town); C. Gagiano (Bloemfontein); United Kingdom: M. Reveley (Leicester); T. Sharma (London); United States of America: J. Csernansky (St. Louis); L. DeLisi (Stony Brook); J. Lauriello (Albuquerque); T. Manschreck (Fall River); J. Pahl (Oklahoma City); N. Schooler (Pittsburgh); S. Schulz (Cleveland); S. Targum (Philadelphia); S. Risch (Charleston).

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N2 - Background: Chronic schizophrenia patients have been sampled for factor analytic studies to identify the factor structure of the Positive and Negative Syndrome Scale (PANSS). Many of these studies have identified a cognitive factor, which may provide useful information about patients for whom formal neuropsychological testing is unavailable. However, the relationship between the clinically rated cognitive factor and performance-based cognitive test scores has not been thoroughly examined, particularly in patients who are early in the course of illness. Objectives: The validity of the PANSS cognitive factor was examined in a sample of antipsychotic naïve, first-episode psychosis patients and the PANSS items that best predicted cognitive functioning were identified. Method: PANSS scores and performance on a battery of cognitive tests from the baseline assessment of a clinical trial of 167 neuroleptic naïve patients with schizophrenia-like illnesses were analyzed. Results: Factor analysis revealed a five-factor model that was consistent with previously described factor models from samples of chronically treated patients. There were modest correlations (less than r=0.44) between the derived cognitive factor and six of the neuropsychological test variables (Wisconsin Card Sorting Test total errors and number of categories correctly sorted, WMS-R immediate and delayed recall scores, Category Fluency total score, and WAIS-R digit symbol). Five PANSS items (P6, N5, N6, G2, and G10) were identified that predicted global cognitive functioning; however, 66% of the variance in cognitive functioning remained unexplained. Conclusions: A PANSS cognitive factor can be identified in first-episode, neuroleptic naïve patients. However, clinical ratings of cognitive deficits lack sensitivity and specificity and thus should not be relied upon fully.

AB - Background: Chronic schizophrenia patients have been sampled for factor analytic studies to identify the factor structure of the Positive and Negative Syndrome Scale (PANSS). Many of these studies have identified a cognitive factor, which may provide useful information about patients for whom formal neuropsychological testing is unavailable. However, the relationship between the clinically rated cognitive factor and performance-based cognitive test scores has not been thoroughly examined, particularly in patients who are early in the course of illness. Objectives: The validity of the PANSS cognitive factor was examined in a sample of antipsychotic naïve, first-episode psychosis patients and the PANSS items that best predicted cognitive functioning were identified. Method: PANSS scores and performance on a battery of cognitive tests from the baseline assessment of a clinical trial of 167 neuroleptic naïve patients with schizophrenia-like illnesses were analyzed. Results: Factor analysis revealed a five-factor model that was consistent with previously described factor models from samples of chronically treated patients. There were modest correlations (less than r=0.44) between the derived cognitive factor and six of the neuropsychological test variables (Wisconsin Card Sorting Test total errors and number of categories correctly sorted, WMS-R immediate and delayed recall scores, Category Fluency total score, and WAIS-R digit symbol). Five PANSS items (P6, N5, N6, G2, and G10) were identified that predicted global cognitive functioning; however, 66% of the variance in cognitive functioning remained unexplained. Conclusions: A PANSS cognitive factor can be identified in first-episode, neuroleptic naïve patients. However, clinical ratings of cognitive deficits lack sensitivity and specificity and thus should not be relied upon fully.

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The relationship of neuropsychological test performance with the PANSS in antipsychotic naïve, first-episode psychosis patients

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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