Cognitive-perceptual deficits and symptom correlates in first-episode schizophrenia.

BACKGROUND

Thought disorder and visual-perceptual deficits have been well documented, but their relationships with clinical symptoms and cognitive function remain unclear. Cognitive-perceptual deficits may underscore clinical symptoms in schizophrenia patients.

AIM

This study aimed to explore how thought disorder and form perception are related with clinical symptoms and cognitive dysfunction in first-episode schizophrenia.

SETTING

Forty-two patients with a first-episode of schizophrenia, schizophreniform or schizoaffective disorder were recruited from community clinics and state hospitals in the Cape Town area.

METHODS

Patients were assessed at baseline with the Rorschach Perceptual Thinking Index (PTI), the Positive and Negative Syndrome Scale (PANSS) and the MATRICS Cognitive Consensus Battery (MCCB). Spearman correlational analyses were conducted to investigate relationships between PTI scores, PANSS factor analysis-derived domain scores and MCCB composite and subscale scores. Multiple regression models explored these relationships further.

RESULTS

Unexpectedly, poor form perception (X- %) was inversely correlated with the severity of PANSS positive symptoms ( = -0.42, = 0.02). Good form perception (XA%) correlated significantly with speed of processing ( = 0.59, < 0.01), working memory ( = 0.48, < 0.01) and visual learning ( = 0.55, < 0.01). PTI measures of thought disorder did not correlate significantly with PANSS symptom scores or cognitive performance.

CONCLUSIONS

Form perception is associated with positive symptoms and impairment in executive function during acute psychosis. These findings suggest that there may be clinical value in including sensory-perceptual processing tasks in cognitive remediation and social cognitive training programmes for schizophrenia patients.