REMEDIATION OF WISCONSIN CARD SORTING TEST-PERFORMANCE IN SCHIZOPHRENIA - A CONTROLLED-STUDY

Previous studies have shown encouraging plasticity in some schizophren ic patients' Wisconsin Card Sorting Test (WCST) performance while rece iving detailed specific instructions on task and reinforcement. The pr esent study examines the efficacy of a modified procedure for WCST adm inistration that bound schizophrenic patients to use a conceptually dr iven cognitive strategy without any instruction or reinforcement. The schizophrenics' results were also compared to those obtained with the same procedure from a matched control sample. By using this procedure, 63.2% of WCST schizophrenic poor performers dramatically improved the ir results. Schizophrenic poor performers who did not achieve remediat ion were of a younger age at onset and had more negative symptoms. Thi s pattern was strictly associated with more perseverative errors on WC ST that increased even more when the conceptually driven processing wa s forced. Our findings could have important implications for our under standing of the underlying cognitive deficit of the poor neuropsycholo gical performance and allow the distinction of schizophrenic subtypes who show peculiar features that probably reflect a different pathophys iology and would potentially benefit from different modalities of trea tment and rehabilitation.