Cognitive and communication impairments are just some of the symptoms of schizophrenia. People usually begin showing signs of psychosis and schizophrenia in adolescence and young adulthood. Other symptoms include visual, verbal, and auditory hallucinations, lack of affect, social withdrawal, attention problems, executive function deficits and memory impairment. Neurological tests, including event-related potentials (ERPs), are widely used to assess individuals with early symptoms of psychosis for risk of schizophrenia. In fact, the earlier schizophrenia can be diagnosed in those at risk, the better the outcome. Research has shown that the longer the duration of untreated psychosis (DUP), the worse the outcome for the individual.
Some of the barriers to testing include length of test time. Many neurophysiological tests can take upward of 30 minutes to administer. The nature of symptoms associated with psychosis often prevents these tests from being administered. But ERPs and other methods are often conducted in briefer time periods.
Therefore, Yuko Higuchi of the Department of Neuropsychiatry at the University of Toyama Graduate School of Medicine and Pharmaceutical Science in Japan wanted to see if short duration ERPs focused on verbal fluency could predict which individuals at risk for psychosis would later develop schizophrenia. Higuchi used duration mismatch negativity tests (dMMN) on auditory cues in a sample of 17 individuals with early signs of psychosis, 31 with schizophrenia and 20 with neither psychosis nor schizophrenia. The levels of verbal fluency and cognitive performance were measured during dMMN tests.
Higuchi discovered that the at-risk participants who later developed schizophrenia had reduced dMMN measurements, as well as impairments in working memory, information processing, attention, and verbal skills when compared to those who did not. The participants with schizophrenia had the highest level of dMMN impairments. These findings suggest that people with symptoms of psychosis who are at risk for schizophrenia may have poorer verbal skills than those who are not at risk.
Although the verbal fluency test was short in duration and may be easier to use on some clients, it should not take the place of other measures that provide additional cognitive and neurological insight. Higuchi added, “Therefore, combined administration of neurophysiological and neuropsychological assessments would facilitate screening procedures, depending on the condition of patients.” In all, Higuchi hopes that these results aid in the efforts to provide early identification of those most at risk for schizophrenia.
Higuchi Y, Sumiyoshi T, Seo T, Miyanishi T, Kawasaki Y, et al. (2013) “Mismatch Negativity and Cognitive Performance for the Prediction of Psychosis in Subjects with At-Risk Mental State.” PLoS ONE 8(1): e54080. doi:10.1371/journal.pone.0054080
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