Kraepelin and Bleuler had it right: people with schizophrenia have deficits sustaining attention over time.

An inability to sustain attention was noted in the original clinical descriptions of schizophrenia, but the vast majority of experimental studies have failed to report a performance decrement over time, calling this observation into question. To test for such deficits when task conditions conform to basic science taxonomy for the validity of sustained attention tasks, a dynamic stimulus array was presented in which targets, differing subtly from standard stimuli, were presented infrequently and unpredictably. Both people with schizophrenia (PSZ, n=40) and healthy control subjects (HCS, n=29) displayed a reduction in hit rate and an increase in reaction time (RT) from the first to the second 5-min period. Thereafter, the hit rate of HCS recovered and remained stable, while that of PSZ continued to decline. When performance at task onset was equated between groups, the decrement over time in PSZ remained of the same robust magnitude. Thus, when the nature of the task challenges sustaining attention over time, PSZ display a clear deficit in this ability.