T89. DEFINING COGNITIVE “NORMALITY” IN SCHIZOPHRENIA: PREVALENCE OF BROAD AND NARROW CRITERIA AND RELATION TO CLINICAL AND FUNCTIONAL STATUS
Notice bibliographique
Résumé
Cognitive dysfunction is considered a core feature of schizophrenia. Nonetheless, patients with the illness overlap with healthy controls on many tasks, giving rise to the identification of subpopulations with relatively normal cognitive performance. However, the prevalence and implications of these subgroups for understanding schizophrenia are unclear because “normality” criteria vary. Estimates of the frequency of normal range performance in the patient population are as low as 0% and as high as 89%. This study examines the relation between different normality criteria and normality prevalence. It also assesses functional outcome and symptom severity in cognitively normal and impaired subgroups. “Narrow” (IQ) and “broad” (MATRICS Consensus Cognitive Battery; MCCB) cognitive normality criteria were applied to data from schizophrenia (n = 99) and healthy control samples (n = 80). Functional outcome was assessed with the Multidimensional Scale of Independent Functioning (MSIF). The Positive and Negative Syndrome Scale (PANSS) was administered to measure symptom severity. Cognitive normality ranged from 13% (broad criterion) to 47% (narrow criterion) among patients. Patients meeting both broad (MCCB) and narrow (IQ) definitions were functionally disadvantaged compared to cognitively normal controls (t(63) = 7.05, p < .01; t(72) = 9.97, p < .01, respectively). However, cognitively normal patients showed no functional (MSIF) advantage relative to cognitively impaired patients based on both broad and narrow definitions of cognitive normality (t(95) = .43, p = .67; t(74) = -1.04, p = .30, respectively). Functioning did not differ between IQ and MCCB based cognitively normal patients (t(51) = .61, p = .55). Moreover, broad and narrow definitions of cognitive normality were not associated with differences in symptom severities relative to cognitively impaired patients. This held true for both positive (t(97) = 1.39, p = .17; t(76) = -.72, p = .47, broad and narrow definitions, respectively) and negative (t(97) = .98, p = .33; t(76) = -1.07, p = .29, broad and narrow definitions, respectively) symptom severity on the PANSS. Our data show that the prevalence of cognitive performance normality varies widely with the breadth of the normality criterion. However, regardless of the criterion applied, cognitively normal patients remain functionally disadvantaged relative to cognitively normal controls. Perhaps more importantly, however defined, cognitively normal patients demonstrate no advantage in functionality relative to cognitively impaired patients. Thus, patients meeting the broad definition of cognitive normality are not functionally advantaged relative to those meeting the narrow definition. We also found that varying definitions of cognitive normality/impairment have no implications for the severity of psychotic psychopathology in treated outpatients. Overall, the current study suggests that the reported prevalence of cognitive normality in schizophrenia is largely a product of definitional approaches. At the same time, the data cast doubt on the functional importance of preserved and proficient cognition regardless of definition and suggest that cognitive normality does not confer an advantage in terms of reduced symptom severity.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».