Discriminant cognitive factors in responder and non-responder patients with schizophrenia

lTo identify which improvements in cognitive function are associated with s ymptom resolution in schizophrenic patients treated with atypical antipsych otics. Design: a prospective open trial with atypical neuroleptics (risperi done, clozapine, quetiapine). Setting: Inpatient and outpatient units, Inst itute of Psychiatry. Patients: Thirty-nine patients with schizophrenia acco rding to DSM-IV criteria were included. Clinical and cognitive assessment w ere done at baseline (T0) and again after six months of treatment (T2). Twe nty-five patients completed the trial. Interventions: New-generation antips ychotics during six months. Patients were considered as responders if their PANSS score decreased at least 20% (n = 15) and non-responders if it did n ot (n = 10). Outcome measures: a computerized cognitive assessment comprise d tests of short-term-memory (digit span), explicit long-term memory (word pair learning), divided attention, selective attention and verbal fluency ( orthographic and semantic). Clinical assessment included PANSS and ESRS. Re sults: A discriminant function analysis was performed to determine which ch anges in cognitive performance predicted symptomatic response status. Seman tic fluency and orthographic fluency were significant predictors. Together they correctly predicted responder status in 88% of cases. Memory was not a significant predictor of symptomatic response. Conclusion: Verbal fluency discriminated the responder from the non-responder group during a pharmacol ogical treatment. (C) 1999 Editions scientifiques et medicales Elsevier SAS .