© 2000 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
Neurocognitive Deficits and Functional Outcome in Schizophrenia: Are We Measuring the "Right Stuff"?
Department of Psychiatry and Behavioral Sciences, University of California Los Angeles (UCLA)
Department of Psychiatry, University of California San Diego
Department of Psychiatry and Behavioral Sciences, UCLA
Reprint requests should be sent to Dr. M.F. Green, UCLA Neuropsychiatric Institute, 760 Westwood Plaza, C9-420, Los Angeles, CA 900241759.
There has been a surge of interest in the functional consequences of neurocognitive deficits in schizophrenia. The published literature in this area has doubled in the last few years. In this paper, we will attempt to confirm the conclusions from a previous review that certain neurocognitive domains (secondary verbal memory, immediate memory, executive functioning as measured by card sorting, and vigilance) are associated with functional outcome. In addition to surveying the number of replicated findings and tallying box scores of results, we will approach the review of the studies in a more thorough and empirical manner by applying a meta-analysis. Lastly, we will discuss what we see as a key limitation of this literature, specifically, the relatively narrow selection of predictor measures. This limitation has constrained identification of mediating variables that may explain the mechanisms for these relationships.
Keywords: Schizophrenia / neurocognition / functional outcome / social cognition / learning potential
![]()
CiteULike
Connotea
Del.icio.us What's this?
This article has been cited by other articles:
![]() |
W. P. Horan, J. J. Blanchard, L. A. Clark, and M. F. Green Affective Traits in Schizophrenia and Schizotypy Schizophr Bull, August 5, 2008; (2008) sbn083v2. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. W. Heinrichs, N. Ammari, A. A. Miles, and S. McDermid Vaz Cognitive Performance and Functional Competence as Predictors of Community Independence in Schizophrenia Schizophr Bull, July 30, 2008; (2008) sbn095v1. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. M. Eack, C. G. Greeno, M. F. Pogue-Geile, C. E. Newhill, G. E. Hogarty, and M. S. Keshavan Assessing Social-Cognitive Deficits in Schizophrenia With the Mayer-Salovey-Caruso Emotional Intelligence Test Schizophr Bull, July 22, 2008; (2008) sbn091v1. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. S. Herbener Emotional Memory in Schizophrenia Schizophr Bull, July 15, 2008; (2008) sbn081v1. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Harrow and T. H. Jobe How Frequent is Chronic Multiyear Delusional Activity and Recovery in Schizophrenia: A 20-Year Multi-follow-up Schizophr Bull, July 9, 2008; (2008) sbn074v1. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y. Braw, Y. Bloch, S. Mendelovich, G. Ratzoni, G. Gal, H. Harari, A. Tripto, and Y. Levkovitz Cognition in Young Schizophrenia Outpatients: Comparison of First-Episode With Multiepisode Patients Schizophr Bull, May 1, 2008; 34(3): 544 - 554. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. S. Kern, R. P. Liberman, D. R. Becker, R. E. Drake, C. A. Sugar, and M. F. Green Errorless Learning for Training Individuals With Schizophrenia at a Community Mental Health Setting Providing Work Experience Schizophr Bull, March 6, 2008; (2008) sbn010v1. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. M. Grant and A. T. Beck Defeatist Beliefs as a Mediator of Cognitive Impairment, Negative Symptoms, and Functioning in Schizophrenia Schizophr Bull, February 27, 2008; (2008) sbn008v1. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. M. Silverstein, W. D. Spaulding, A. A. Menditto, A. Savitz, R. P. Liberman, S. Berten, and H. Starobin Attention Shaping: a Reward-Based Learning Method to Enhance Skills Training Outcomes in Schizophrenia Schizophr Bull, January 22, 2008; (2008) sbm150v1. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. S. Stone and L. J. Seidman Toward a Model of Memory Enhancement in Schizophrenia: Glucose Administration and Hippocampal Function Schizophr Bull, January 1, 2008; 34(1): 93 - 108. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. G. Ross, B. Wagner, S. Heinlein, and G. O. Zerbe The Stability of Inhibitory and Working Memory Deficits in Children and Adolescents Who are Children of Parents With Schizophrenia Schizophr Bull, January 1, 2008; 34(1): 47 - 51. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Pfennig, E. Littmann, and M. Bauer Neurocognitive Impairment and Dementia in Mood Disorders J Neuropsychiatry Clin Neurosci, November 1, 2007; 19(4): 373 - 382. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. T. Mausbach, P. D. Harvey, S. R. Goldman, D. V. Jeste, and T. L. Patterson Development of a Brief Scale of Everyday Functioning in Persons with Serious Mental Illness Schizophr Bull, November 1, 2007; 33(6): 1364 - 1372. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. K. Schutt, L. J. Seidman, B. Caplan, A. Martsinkiv, and S. M. Goldfinger The Role of Neurocognition and Social Context in Predicting Community Functioning Among Formerly Homeless Seriously Mentally Ill Persons Schizophr Bull, November 1, 2007; 33(6): 1388 - 1396. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Morein-Zamir, D. C. Turner, and B. J. Sahakian A Review of the Effects of Modafinil on Cognition in Schizophrenia Schizophr Bull, November 1, 2007; 33(6): 1298 - 1306. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. J. Sergi, M. F. Green, C. Widmark, C. Reist, S. Erhart, D. L. Braff, K. S. Kee, S. R. Marder, and J. Mintz Social Cognition and Neurocognition: Effects of Risperidone, Olanzapine, and Haloperidol Am J Psychiatry, October 1, 2007; 164(10): 1585 - 1592. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. M. Kurtz, E. Baker, G. D. Pearlson, and R. S. Astur A Virtual Reality Apartment as a Measure of Medication Management Skills in Patients With Schizophrenia: A Pilot Study Schizophr Bull, September 1, 2007; 33(5): 1162 - 1170. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Dickinson, A. S. Bellack, and J. M. Gold Social/Communication Skills, Cognition, and Vocational Functioning in Schizophrenia Schizophr Bull, September 1, 2007; 33(5): 1213 - 1220. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. S. Brekke, M. Hoe, J. Long, and M. F. Green How Neurocognition and Social Cognition Influence Functional Change During Community-Based Psychosocial Rehabilitation for Individuals with Schizophrenia Schizophr Bull, September 1, 2007; 33(5): 1247 - 1256. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. D. Harvey, D. I. Velligan, and A. S. Bellack Performance-Based Measures of Functional Skills: Usefulness in Clinical Treatment Studies Schizophr Bull, September 1, 2007; 33(5): 1138 - 1148. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. S. Kraus and R. S. E. Keefe Cognition as an outcome measure in schizophrenia The British Journal of Psychiatry, August 1, 2007; 191(50): s46 - s51. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. S. E. Keefe and W. S. Fenton How Should DSM-V Criteria for Schizophrenia Include Cognitive Impairment? Schizophr Bull, July 1, 2007; 33(4): 912 - 920. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Morrens, W. Hulstijn, and B. Sabbe Psychomotor Slowing in Schizophrenia Schizophr Bull, July 1, 2007; 33(4): 1038 - 1053. [Abstract] [Full Text] [PDF] |
||||
![]() |
References PsychiatryOnline CME, May 1, 2007; 2007(1): 2 - 2. [Full Text] |
||||
![]() |
A. S. Bellack, M. F. Green, J. A. Cook, W. Fenton, P. D. Harvey, R. K. Heaton, T. Laughren, A. C. Leon, D. J. Mayo, D. L. Patrick, et al. Assessment of Community Functioning in People With Schizophrenia and Other Severe Mental Illnesses: A White Paper Based on an NIMH-Sponsored Workshop Schizophr Bull, May 1, 2007; 33(3): 805 - 822. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. E. Simon, K. Cattapan-Ludewig, S. Zmilacher, D. Arbach, K. Gruber, D. N. Dvorsky, B. Roth, E. Isler, A. Zimmer, and D. Umbricht Cognitive Functioning in the Schizophrenia Prodrome Schizophr Bull, May 1, 2007; 33(3): 761 - 771. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. A. Cornblatt, A. M. Auther, T. Niendam, C. W. Smith, J. Zinberg, C. E. Bearden, and T. D. Cannon Preliminary Findings for Two New Measures of Social and Role Functioning in the Prodromal Phase of Schizophrenia Schizophr Bull, May 1, 2007; 33(3): 688 - 702. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Wykes, C. Reeder, S. Landau, B. Everitt, M. Knapp, A. Patel, and R. Romeo Cognitive remediation therapy in schizophrenia: Randomised controlled trial The British Journal of Psychiatry, May 1, 2007; 190(5): 421 - 427. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. L. Hake, E. Hamera, and M. Rempfer Self-report of Cognitive Functioning and Learning in Schizophrenia Journal of the American Psychiatric Nurses Association, April 1, 2007; 13(2): 93 - 100. [Abstract] [PDF] |
||||
![]() |
A. V. Terry Jr. and S. P. Mahadik Time-Dependent Cognitive Deficits Associated with First and Second Generation Antipsychotics: Cholinergic Dysregulation as a Potential Mechanism J. Pharmacol. Exp. Ther., March 1, 2007; 320(3): 961 - 968. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. F. Reynolds III Assessing the Capacity to Make Everyday Decisions About Functional Problems: Where Does the Field Go From Here? Am J Geriatr Psychiatry, February 1, 2007; 15(2): 89 - 91. [Full Text] [PDF] |
||||
![]() |
S. Hodgins, A. Tengstrom, A. Eriksson, R. Osterman, R. Kronstrand, D. Eaves, S. Hart, C. Webster, D. Ross, A. Levin, et al. A Multisite Study of Community Treatment Programs for Mentally Ill Offenders With Major Mental Disorders: Design, Measures, and the Forensic Sample Criminal Justice and Behavior, February 1, 2007; 34(2): 211 - 228. [Abstract] [PDF] |
||||
![]() |
R. E. Gur, M. E. Calkins, R. C. Gur, W. P. Horan, K. H. Nuechterlein, L. J. Seidman, and W. S. Stone The Consortium on the Genetics of Schizophrenia: Neurocognitive Endophenotypes Schizophr Bull, January 1, 2007; 33(1): 49 - 68. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. K. Chadwick Peer-Professional First-Person Account: Schizophrenia From the Inside--Phenomenology and the Integration of Causes and Meanings Schizophr Bull, January 1, 2007; 33(1): 166 - 173. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Gioia A contextual study of daily living strategies in neurocognitively impaired adults with schizophrenia. Qual Health Res, November 1, 2006; 16(9): 1217 - 1235. [Abstract] [PDF] |
||||
![]() |
R. Goder, J. B. Aldenhoff, M. Boigs, S. Braun, J. Koch, and G. Fritzer Delta Power in Sleep in Relation to Neuropsychological Performance in Healthy Subjects and Schizophrenia Patients J Neuropsychiatry Clin Neurosci, November 1, 2006; 18(4): 529 - 535. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. S. Matza, R. Buchanan, S. Purdon, J. Brewster-Jordan, Y. Zhao, and D. A. Revicki Measuring Changes in Functional Status Among Patients With Schizophrenia: The Link With Cognitive Impairment Schizophr Bull, October 1, 2006; 32(4): 666 - 678. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Patel, B. Everitt, M. Knapp, C. Reeder, D. Grant, C. Ecker, and T. Wykes Schizophrenia Patients With Cognitive Deficits: Factors Associated With Costs Schizophr Bull, October 1, 2006; 32(4): 776 - 785. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. M. Couture, D. L. Penn, and D. L. Roberts The Functional Significance of Social Cognition in Schizophrenia: A Review Schizophr Bull, October 1, 2006; 32(suppl_1): S44 - S63. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Reeder, N. Smedley, K. Butt, D. Bogner, and T. Wykes Cognitive Predictors of Social Functioning Improvements Following Cognitive Remediation for Schizophrenia Schizophr Bull, October 1, 2006; 32(suppl_1): S123 - S131. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. I. Velligan, R. S. Kern, and J. M. Gold Cognitive Rehabilitation for Schizophrenia and the Putative Role of Motivation and Expectancies Schizophr Bull, July 1, 2006; 32(3): 474 - 485. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Barch Introduction to Special Theme Issue Schizophr Bull, July 1, 2006; 32(3): 486 - 488. [Full Text] [PDF] |
||||
![]() |
L. J. Seidman, A. J. Giuliano, C. W. Smith, W. S. Stone, S. J. Glatt, E. Meyer, S. V. Faraone, M. T. Tsuang, and B. Cornblatt Neuropsychological Functioning in Adolescents and Young Adults at Genetic Risk for Schizophrenia and Affective Psychoses: Results from the Harvard and Hillside Adolescent High Risk Studies Schizophr Bull, July 1, 2006; 32(3): 507 - 524. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. W. Twamley and P. D. Harvey The Importance of Cognition in the Conceptualization of both Dementia and Severe Mental Illness in Older People. Am J Geriatr Psychiatry, May 1, 2006; 14(5): 387 - 390. [Full Text] [PDF] |
||||
![]() |
A. E. Thornton, J. X. Van Snellenberg, A. A. Sepehry, and W. G. Honer The impact of atypical antipsychotic medications on long-term memory dysfunction in schizophrenia spectrum disorder: a quantitative review J Psychopharmacol, May 1, 2006; 20(3): 335 - 346. [Abstract] [PDF] |
||||
![]() |
W. P Horan, A. M Kring, and J. J Blanchard Anhedonia in Schizophrenia: A Review of Assessment Strategies Schizophr Bull, April 1, 2006; 32(2): 259 - 273. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. D Harvey, D. Koren, A. Reichenberg, and C. R Bowie Negative Symptoms and Cognitive Deficits: What Is the Nature of Their Relationship? Schizophr Bull, April 1, 2006; 32(2): 250 - 258. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Koren, L. J Seidman, M. Goldsmith, and P. D Harvey Real-World Cognitive--and Metacognitive--Dysfunction in Schizophrenia: A New Approach for Measuring (and Remediating) More "Right Stuff" Schizophr Bull, April 1, 2006; 32(2): 310 - 326. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. R. Bowie, A. Reichenberg, T. L. Patterson, R. K. Heaton, and P. D. Harvey Determinants of Real-World Functional Performance in Schizophrenia Subjects: Correlations With Cognition, Functional Capacity, and Symptoms Am J Psychiatry, March 1, 2006; 163(3): 418 - 425. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. S.E. Keefe, M. Poe, T. M. Walker, J. W. Kang, and P. D. Harvey The Schizophrenia Cognition Rating Scale: An Interview-Based Assessment and Its Relationship to Cognition, Real-World Functioning, and Functional Capacity Am J Psychiatry, March 1, 2006; 163(3): 426 - 432. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. J. Sergi, Y. Rassovsky, K. H. Nuechterlein, and M. F. Green Social Perception as a Mediator of the Influence of Early Visual Processing on Functional Status in Schizophrenia Am J Psychiatry, March 1, 2006; 163(3): 448 - 454. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. W Palmer and D. V Jeste Relationship of Individual Cognitive Abilities to Specific Components of Decisional Capacity Among Middle-Aged and Older Patients With Schizophrenia Schizophr Bull, January 1, 2006; 32(1): 98 - 106. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. C Marson, R. Savage, and J. Phillips Financial Capacity in Persons with Schizophrenia and Serious Mental Illness: Clinical and Research Ethics Aspects Schizophr Bull, January 1, 2006; 32(1): 81 - 91. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. V Jeste, C. A Depp, and B. W Palmer Magnitude of Impairment in Decisional Capacity in People With Schizophrenia Compared to Normal Subjects: An Overview Schizophr Bull, January 1, 2006; 32(1): 121 - 128. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. CAIRNS, C. MADDOCK, A. BUCHANAN, A. S. DAVID, P. HAYWARD, G. RICHARDSON, G. SZMUKLER, and M. HOTOPF Prevalence and predictors of mental incapacity in psychiatric in-patients The British Journal of Psychiatry, October 1, 2005; 187(4): 379 - 385. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. P. GOOD, I. KISS, C. BUITEMAN, H. WOODLEY, Q. RUI, D. WHITEHORN, and L. KOPALA Improvement in cognitive functioning in patients with first-episode psychosis during treatment with quetiapine: an interim analysis The British Journal of Psychiatry, September 1, 2002; 181 (43): s45 - s49. [Abstract] [Full Text] [PDF] |
||||
![]() |
N Hadas-Lidor, N Katz, S Tyano, and A Weizman Effectiveness of dynamic cognitive intervention in rehabilitation of clients with schizophrenia Clinical Rehabilitation, April 1, 2001; 15(4): 349 - 359. [Abstract] [PDF] |
||||











