HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS Psychiatric Bulletin Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by JOYCE, E. Articles by BARNES, T. Search for Related Content PubMed Articles by JOYCE, E. Articles by BARNES, T.

Executive dysfunction in first-episode schizophrenia and relationship to duration of untreated psychosis: the West London Study^*

Imperial College Faculty of Medicine, London

TREVOR ROBBINS, PhD

University of Cambridge

THOMAS BARNES, FRCPsych

Imperial College Faculty of Medicine, London

Correspondence: Dr Eileen Joyce, Imperial College Faculty of Medicine, Charing Cross Site, St Dunstan's Road, London W6 8RP. e-mail: e.joyce{at}ic.ac.uk

Declaration of interest None.

Funding from The Wellcome Trust.

^* Presented in part at the European First Episode Schizophrenia Network Meeting, Whistler BC, Canada, 27 April 2001.

Background Many studies have demonstrated early generalised cognitive impairment in schizophrenia.

Aims To examine executive function in first-episode schizophrenia, characterise the nature of the impairment and specify any relationships with symptoms and duration of untreated psychosis (DUP).

Method Patients (n=136) and normal controls (n=81) were assessed with the Cambridge Automated Neuropsychological Test Battery, National Adult Reading Test IQ, and Scales for the Assessment of Positive and Negative Symptoms.

Results Memory and executive impairments in patients were independent of IQ level. Spatial working memory was impaired because of inadequate strategy use. On a planning task, patients showed reduced planning times and suboptimal problem-solving. On an attentional set-shifting task, 75% of patients were able to perform an extra-dimensional shift thought to be a core attribute of prefrontal cortex function. Those who failed had significantly longer DUP.

Conclusions Prefrontal cortex function deteriorates at the onset of psychosis and continues to worsen over time.

This article has been cited by other articles:

				G. Cirulli Clozapine prescribing in adolescent psychiatry: survey of prescribing practice in in-patient units Psychiatr. Bull., October 1, 2005; 29(10): 377 - 380. [Abstract] [Full Text] [PDF]

				Y. V. Gopal and H. Variend First-episode schizophrenia: review of cognitive deficits and cognitive remediation Advan. Psychiatr. Treat., January 1, 2005; 11(1): 38 - 44. [Abstract] [Full Text] [PDF]

				S. LEWIS The European First-Episode Schizophrenia Network The British Journal of Psychiatry, September 1, 2002; 181 (43): s1 - s2. [Full Text] [PDF]