Impaired Wisconsin Card Sorting Test performance in first-episode schizophrenia: Resource or motivation deficit?

Patients with first-episode schizophrenia (n = 27) and age- and education-m atched healthy controls (n = 27) were administered the standard version of the Wisconsin Card Sorting Test (WCST), the Wechsler Adult Intelligence Sca le-Revised (WAIS-R), and the Rorschach according to the Comprehensive Syste m (CS). Schizophrenic patients achieved a significantly lower full-scale IQ and made more perseverative responses and achieved fewer categories on the WCST than the healthy control group. No significant associations were obse rved between effort or motivation and WCST performance. Schizophrenic patie nts who made more perseverative responses tended to be impoverished in term s of available resources, and functioned in a simplistic way when attending to details of the stimulus field. First-episode schizophrenics are able to generate motives and initiate goal-directed activity, but some of them fai l to achieve their goals because the cognitive abilities and available reso urces required for effective planning, purposeful action, or effective perf ormance are impaired. Copyright (C) 2000 by W.B. Saunders Company.