Executive function in first-episode schizophrenia: A three-year longitudinal study of an ecologically valid test

Kristy C. M. LIU, Raymond C. K. CHAN, Ka Shing Kevin CHAN, Jennifer Y. M. TANG, Cindy P. Y. CHIU, May M. L. LAM, Sherry K. W. CHAN, Gloria H. Y. WONG, Christy L. M. HUI, Eric Y. H. CHEN

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Abstract

Executive function impairment is a key cognitive deficit in schizophrenia. However, traditional neuropsychological tests of executive function may not be sensitive enough to capture the everyday dysexecutive problems experienced by patients. Additionally, existing literature has been inconsistent about longitudinal changes of executive functions in schizophrenia. The present study focuses on examining the longitudinal change of executive functions in schizophrenia using the Modified Six Elements Test (MSET) that was developed based on the Supervisory Attentional System model and shown to be sensitive to everyday dysexecutive problems. In the present study, MSET performance was assessed in 31 medication-naïve first-episode schizophrenic patients at four times over a period of three years, while the 31 normal controls were assessed once. Patients demonstrated impairment in MSET as compared to controls. Importantly, the MSET impairment persisted from the medication-naïve state to clinical stabilization and the three years following the first psychotic episode though patients improved in a conventional executive test (Modified Wisconsin Card Sorting Test). Performance was not related to intelligence, educational level, symptom changes, age-of-onset, or duration of untreated psychosis. Better MSET performance at medication-naïve state predicted improvement in negative and positive symptoms over the three-year period. These findings may suggest that MSET impairment is a primary deficit in schizophrenia that occurs early in the course of the illness and remains stable irrespective of clinical state for at least three years following the first episode of schizophrenia. Copyright © 2010 Elsevier B.V. All rights reserved.
Original languageEnglish
Pages (from-to)87-92
JournalSchizophrenia Research
Volume126
Issue number1-3
DOIs
Publication statusPublished - Mar 2011

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Executive Function
Longitudinal Studies
Schizophrenia
Neuropsychological Tests
Intelligence
Age of Onset
Psychotic Disorders

Citation

Liu, K. C. M., Chan, R. C. K., Chan, K. K. S., Tang, J. Y. M., Chiu, C. P. Y., Lam, M. M. L., . . . Chen, E. Y. H. (2011). Executive function in first-episode schizophrenia: A three-year longitudinal study of an ecologically valid test. Schizophrenia Research, 126(1-3), 87-92. doi: 10.1016/j.schres.2010.11.023

Keywords

  • First-episode schizophrenia
  • Medication-naïve
  • Longitudinal
  • Cognitive function
  • Executive function
  • Six elements