OBJECTIVES: This study was aimed to investigate the neurocognitive functioning of patients with remitted bipolar disorder and compare with schizophrenic patients' neurocognitive functioning. METHODS: This issue was addressed by comparing remitted DSM-IV diagnosed bipolar, schizophrenics patients and controls on several clinical and neurocognitive measures. Clinical state was assessed using the Positive and Negative Syndrome Scale (PANSS), Young Mania Rating Scale (YMRS), and Montgomery-Asberg Depression Rating Scale (MADRS). Neurocognitive measures included the KWIS, WMS-III, Korean California Verbal Learning Test (K-CVLT), Wisconsin Card Sorting Test (WCST), Rey-Osterrieth Complex Test (RCFT), and Color Trails Test (CTT). Thirty-two subjects with remitted bipolar disorder, twenty-four remitted schizophrenia and twelve normal controls were studied. RESULTS: Analysis of variance (ANOVA) revealed no differences across groups on age, education and IQ. With respect to neurocognitive test performance, bipolar disorder patients and schizophrenic patients were similar and both groups were impaired compared to normal controls. Two diagnosed groups have persistent impairments in neurocognitive function, particularly in the domains of declarative memory. CONCLUSION: The results provide support for the view that remitted patients with bipolar disorder suffer cognitive impairment.
Bipolar Disorder ; California ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Schizophrenia ; Sensitivity and Specificity ; Verbal Learning ; Wisconsin

OBJECTIVES: The long-term outcome of schizophrenia is still considered variable and inconclusive. We performed a one-year prospective observational study to investigate the longitudinal outcomes in patients with recent-onset schizophrenia. The primary purpose was to determine the descriptive outcomes in terms of symptom remission and psychosocial function. The secondary purpose was to identify predictor variables associated with the outcomes. METHODS: Patients experiencing their first episode of psychosis or hospitalization within the past 2 years with a diagnosis of DSM-IV schizophrenia were included. Clinical symptoms were assessed monthly using Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS) and Clinical Global Impression (CGI) scale. Psychosocial function was measured using PSYCH-UP (Psychosocial symptoms you currently have, follow-up version) and Heinrichs' Quality of Life Scale (QLS) at baseline, 6, and 12 months and Global Assessment of Functioning (GAF) monthly. Remission was defined on the basis of overall, and psychotic core symptoms as having 1) BPRS total score < or =36, and 2) Each individual item score of core psychotic items (conceptual disorganization, suspiciousness, hallucinatory behavior, unusual thought content) < or =3, and 3) CGI severity score < or =3, and 4) Duration of remission at least for 2 consecutive months. To identify the predictive variables for the outcome, relationships between time to remission and various clinical variables were examined using Cox proportional hazards model. RESULTS: A total of 49 patients with schizophrenia were enrolled in this study. The proportions of patients with symptom remission were 54.5% (24/44, drop outs=5) at 3 months, 55.3% (21/38, drop outs=11) at 6 months, and 64.3% (18/28, drop outs=21) at 12 months. Mean time to remission was 3.76+/-2.43 (s.d.) months, and the mean duration of remission was 7.54+/-2.99 months. Significantly longer time to remission was predicted by higher SANS total score at baseline in various predictor variables (p=0.01). Impairments of psychosocial function measured using PSYCH-UP and QOL were significantly improved at the end of this study, but still remained at mild to moderate level. SANS total score and GAF score significantly correlated with most of the items related to psychosocial function at 12 months. The proportion of the patients with GAF score > or =60 increased from 6.1% at baseline to 85.8% at 12 months. Of the patients who were in remission at 12 months, 95.5% obtained GAF score > or =60. CONCLUSION: This study showed 64.3% of symptom remission rate in patients with recent-onset schizophrenia. Symptom remission was accompanied by significant improvement of global function. The severity of negative symptom at baseline appeared to be a significant predictor for time to remission. Psychosocial function was improved at the end of this study, but impairments still remained at mild to moderate level. GAF score and negative symptoms significantly correlated with psychosocial function.
Brief Psychiatric Rating Scale ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Follow-Up Studies ; Hospitalization ; Humans ; Observational Study* ; Proportional Hazards Models ; Prospective Studies* ; Psychotic Disorders ; Quality of Life ; Schizophrenia*