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Schizophrenia Bulletin Advance Access published online on April 9, 2007
Schizophrenia Bulletin, doi:10.1093/schbul/sbm024
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© The Author 2007. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Clinicians' Concepts of the Cognitive Deficits of Schizophrenia

Elizabeth Bromley1,2–4
2 Semel Institute Health Services Research Center, University of California, Los Angeles, 10920 Wilshire Boulevard, Suite 300, Los Angeles, CA 90024-6505
3 Foundation for Psychocultural Research, PO Box 826, Pacific Palisades, CA 90272
4 Veterans Affairs Desert Pacific Mental Illness Research, Education and Clinical Center, West Los Angeles VA Healthcare Center, 11301 Wilshire Blvd, Bldg 210A, Room 103, Los Angeles, CA 90073

1 To whom correspondence should be addressed; e-mail: ebromley{at}ucla.edu

Several compounds to improve cognition in schizophrenia are being studied in clinical trials, but little is known about how clinicians conceptualize the cognitive deficits of schizophrenia. In a pilot study, the author asked 40 psychiatrists 3 brief questions about the clinical presentation of cognitive deficits. Descriptions of cognitive deficits show high variability. Informants describe phenomenology like follow-through, attention, and emptiness as indicative of cognitive impairment. Informants' concepts of cognitive deficits overlap substantially with positive, negative, and thought disorder symptoms. Clinicians' concepts are complex and contextualized, in contrast to the discrete skills measured by neuropsychological tests. Results suggest that appropriate prescribing of cognition-enhancing medications may be challenging.

Keywords: neurocognition / schizophrenia / prescribing


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