The Relationship between Attention/Vigilance and Symptom Severity in Schizophrenic Patients

Article excerpt

Objective: In schizophrenia, neurocognitive functions are one to two standard deviations below the normal controls and these deficits have a significant relationship with overall functioning and poor outcome. According to this fact, it is important to investigate the factors that effect neurocognition in schizophrenic patients. This study was carried out to demonstrate the relationship between attention/vigilance and some demographic and clinical variables in Iranian schizophrenic patients.

Methods: This was a cross-sectional study; the participants were 60 Iranian schizophrenic patients. They were assessed using the Positive and Negative Syndrome Scale, and the Continuous Performance Test.

Results: No significant relationship was found between gender, age, education, Positive and Negative Syndrome Scale scores and CPS scores.

Conclusions: Our findings suggest that contrary to some domains of cognitive functions, in schizophrenia, attention/vigilance is not influenced by severity of symptoms.

Keywords: schizophrenia, attention, symptom severity

Iran J Psychiatry 2012; 7:22-25

The neurocognitive abilities include memory, attention/vigilance, executive functioning, speed of processing, working memory and problem solving.

Neurocognitive impairment in schizophrenic patients is clinically significant. Studies have shown a significant relationship between neurocognitive deficits and lower social, interpersonal and occupational functioning, lower quality of life and poor outcome (1-5)

In schizophrenia, neurocognitive functions are one to two standard deviations below the normal controls, and some of these impairments are present in schizophrenic patients even before the onset of schizophrenia; sometimes some of the patients' siblings who never represent psychosis show some degree of neurocognitive impairments too. (5, 6). According to the significant role of neurocognitive functions in patients' function, it is important to investigate the factors that influence neurocognition.

Some studies conducted on schizophrenic patients have shown a relationship between cognitive functions and some demographic and clinical factors such as age, gender, duration of disorder, severity of positive and negative symptoms and smoking habits (7-11). The

aim of this study was to determine the relationship between gender, age, the Positive and Negative Syndrome Scale (PANSS) score and attention/vigilance (as a neurocognitive function) in Iranian schizophrenic patients.

Materials and Method

This was a cross-sectional study; the participants were 60 schizophrenic patients consecutively admitted to outpatient service in a university hospital named Iran Hospital of Psychiatry. This center has no selective admission policy and admits patients from all over the country.

Diagnosis of schizophrenia was made by an experienced psychiatrist after obtaining an informed written consent and by reviewing medical records and utilizing the Structured Clinical Interview for DSM-IV disorders (SCID-1). The validity and reliability of the Persian version of SCID-I has been shown validated on a large sample of Iranian patients. (12)

Inclusion criteria were: 1- Diagnosis of schizophrenia for at least 2 years; 2- Maintenance of main antipsychotic drug therapy for at least 8 weeks; 3-Age range of 20-65 years; 4- No mental retardation; 5-No deficit which interfere with doing CPT e.g. normal or corrected vision; 6-No systemic or neurologic disease; 7- No electroconvulsive therapy in the last 5 years; 8- No lifetime history of substance dependence; 9-No

history of head trauma.

Patients were assessed using the Positive and Negative Syndrome Scale (PANSS) which is a 30- item instrument with three subscales evaluating positive and negative symptoms and global psychopathology. The PANSS was scored by summation of ratings across items, such that the potential ranges are 0-42 for the Positive and Negative Scales, and 16-112 for the General Psychopathology Scale. …