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Schizophrenia Bulletin Advance Access originally published online on April 25, 2008
Schizophrenia Bulletin 2008 34(6):1035-1041; doi:10.1093/schbul/sbn028
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© The Author 2008. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Impairments in Cognition Across the Spectrum of Psychiatric Disorders: Evidence From a Swedish Conscript Cohort

Anthony S. David1,2, Stanley Zammit3, Glyn Lewis4, Christina Dalman5 and Peter Allebeck6
2 Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King's College, PO Box 68, London SE5 8AF, UK
3 Department of Psychological Medicine, University Hospital of Wales, Cardiff CF14 4XN, UK
4 Division of Psychiatry, University of Bristol, Bristol, UK
5 Department of Psychiatric Epidemiology, Stockholm Centre of Public Health, Stockholm, Sweden
6 Department of Social Medicine, Karolinska Institute, Stockholm, Sweden

1 To whom correspondence should be addressed; tel: +44 (0)20 7 848 0138, fax: +44 (0)20 7 848 0572, e-mail: a.david{at}iop.kcl.ac.uk.

It is well established that cognitive deficits are an almost invariable component of the schizophrenia syndrome. Much less is known about the association of cognitive deficits and the range of psychiatric disorders. The current study made use of a Swedish conscript cohort which included an IQ assessment and full psychiatric evaluation at conscription of all 18- to 19-year-old males. It was found that reduced intellectual functioning was found in association with psychosis and neurotic disorders including depression, personality disorders, alcoholism, and drug dependence. The effect was particularly strong for alcoholism. This presumably represents a combination of premorbid deficits (as demonstrated in those who developed schizophrenia some years later) plus coincident impairments. The direction of causality of this latter association is likely to be both forward and reverse. Different cognitive subtests showed varied strengths of association: "mechanical ability/knowledge," which might reflect planning and reasoning more than the other subtests, had the strongest effect. Cognitive deficits are widespread in psychiatric disorders and should be taken into account in clinical interactions.

Keywords: IQ / psychosis / cognition / premorbid


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