Neuropsychological differences between first-admission schizophrenia and psychotic affective disorders

Objective: The study compared the neuropsychological functioning of patient s with first-admission schizophrenia with that of patients with first-admis sion psychotic affective disorders. Method: Data came from the Suffolk County Mental Health Project, an epidemi ological study of first-admission psychotic disorders. Subjects with a diag nosis of schizophrenia (N=102) and psychotic affective disorders, including bipolar disorder with psychotic features (N=72) and major depressive disor der with psychotic features (N=49), were compared on a battery of neuropsyc hological tests administered 2 years after the index admission. Results: Subjects with schizophrenia performed worse than those with the ps ychotic affective disorders, even after adjusting the results for differenc es in demographic characteristics and general intellectual functioning. The most consistent differences were on tests of attention, concentration, and mental tracking. The two psychotic affective disorder groups were indistin guishable in performance on the neuropsychological tests. Conclusions: Even early in its course, schizophrenia is distinguishable fro m psychotic affective disorders by global and specific neuropsychological d eficits. These deficits might contribute to the disability and poor outcome associated with schizophrenia in the mid- and long-term course.