ABSTRACT
BACKGROUND: The number of separable cognitive dimensions in schizophrenia has been debated. Guided by the extant factor analytic literature, the NIMH Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative selected seven cognitive domains relevant to treatment studies in schizophrenia: speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. These domains are assessed in the MATRICS Consensus Cognitive Battery (MCCB). The aim of this study was to conduct a confirmatory factor analysis (CFA) of the beta battery of the MCCB to compare the fit of the MATRICS consensus seven-domain model to other models in the current literature on cognition in schizophrenia. METHOD: Using data from 281 schizophrenia outpatients, we compared the seven correlated factors model with alternative models. Specifically, we compared the 7-factor model to (a) a single-factor model, (b) a three correlated factors model including speed of processing, working memory, and general cognition, and (c) a hierarchical model in which seven first-order factors loaded onto a second-order general cognitive factor. RESULTS: Multiple fit indices indicated the seven correlated factors model was the best fit for the data and provided significant improvement in model fit beyond the comparison models. CONCLUSIONS: These results support the assessment of these seven cognitive dimensions in clinical trials of interventions to improve cognition in schizophrenia. Because these cognitive factors are separable to some degree, it is plausible that specific interventions may have differential effects on the domains.
Subject(s)
Cognition , Neuropsychological Tests , Schizophrenic Psychology , Attention , Factor Analysis, Statistical , Humans , Memory , Psychometrics , Schizophrenia , United StatesABSTRACT
BACKGROUND: Although many studies have assessed cognitive functioning in first-episode schizophrenia (FESz), the pattern and severity of impairment across cognitive domains remain unclear. Moreover, few studies have directly compared the pattern of cognitive performance between FESz and chronic schizophrenia (CSz). In this study we examined the cognitive impairment profile in FESz using a standardized neurocognitive battery (MATRICS Consensus Cognitive Battery; MCCB). METHODS: MCCB data were compared from 105 FESz patients, 176 CSz patients and 300 non-psychiatric (NP) participants. Mixed model analysis evaluated group differences in MCCB profiles and relative strengths and weaknesses in the MCCB profiles of patients. Clinical implications of MCCB performance were also examined; we compared the proportion of participants from each group who exhibited clinically-significant global cognitive impairment based on the MCCB Overall Composite score. RESULTS: FESz and CSz showed impaired performance across all MCCB domains relative to NP. With the exception of relative preservation of working memory and social cognition in FESz, the MCCB domain scores were similar in FESz and CSz. The distribution of impairment on the Overall Composite score did not significantly differ between FESz and CSz; compared to NP, both patient groups were overrepresented in moderate and severe impairment categories. CONCLUSION: The pattern, magnitude, and distribution of severity of impairment in FESz were similar to that observed in CSz. However, early in the illness, there may be relative sparing of working memory and social cognition.
Subject(s)
Cognition , Schizophrenic Psychology , Acute Disease , Chronic Disease , Cognition Disorders/chemically induced , Cognition Disorders/complications , Cognition Disorders/drug therapy , Disease Progression , Female , Humans , Male , Memory, Short-Term , Neuropsychological Tests , Psychiatric Status Rating Scales , Schizophrenia/complications , Schizophrenia/diagnosis , Schizophrenia/drug therapy , Social Perception , Young AdultABSTRACT
"This paper examines data from a mainland Scotland survey of household migration into owner-occupied properties identified from the Register of Sasines. Plotting of movements reveals migration patterns, but of arguably greater interest are the increasingly segmented and largely unexplored household decisions which drive migration. The purpose of the survey was to reveal something of these migration processes. Overview results presented here confirm that most moves are short distance, reasons for moving differ according to distance travelled, and although employment remains important for long-distance moves, its significance has declined in favour of quality of life considerations."
Subject(s)
Employment , Family Characteristics , Health Services Accessibility , Population Dynamics , Quality of Life , Demography , Developed Countries , Economics , Emigration and Immigration , Europe , Geography , Population , Residence Characteristics , Scotland , Social Welfare , United KingdomABSTRACT
"Inadequacies of the present migration data supply system in Scotland have been recently highlighted. The purpose of the present item is to enlarge upon problems of monitoring migration and in particular to draw attention to difficulties encountered in the use of the Register of Sasines as a migration data source. Finally, recent progress among Scottish local authorities in the matter of small area population estimation is documented."