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Reduced functioning observed in antisocial schizophrenics


23/3/2009



Comparing neuropsychological functioning in schizophrenia patients with and without antisocial behavior

MedWire News: Schizophrenia patients with antisocial behavior appear to have reduced intellectual functioning and memory dysfunction compared with other patients and may require different management, say US scientists.

Previous studies have revealed that, compared with other schizophrenia patients, antisocial schizophrenics have, among others, structural and functional differences in frontal and temporal regions, homozygosity of the low-activity catechol O-methyltransferase genotype, obstetrical factors, and electrodermal deficits. However, the neuropsychologic correlates have not been thoroughly examined.

To investigate further, a team led by Robert Schug, from the University of Southern California in Los Angeles, conducted a search of the MEDLINE and PsychInfo databases and unpublished data for studies of schizophrenia patients with and without antisocial behavior and individuals with antisocial behavior, with and without schizophrenia, comparing intellectual abilities and neuropsychologic functioning.

In all, 45 studies were found to meet the inclusion criteria and included in a meta-analysis. The studies yielded a total of 1212 antisocial schizophrenia patients, 863 schizophrenia-only patients, and 721 antisocial-only individuals.

Compared with antisocial-only individuals, antisocial schizophrenia patients had deficits in general intellectual functioning, verbal and performance IQ, attention, executive function, and memory analyses. Antisocial schizophrenia patients also had, compared with schizophrenia-only patients, deficits in generalized intellectual functioning, memory, and specific executive function analyses.

The findings were unaffected by analysis by age and year of study publication. While gender had an impact on performance IQ scores and the definition of schizophrenia used affected motor performance scores, there were no other effects from these two variables, the team notes in the journal Clinical Psychology Review.

They write: “Identifying a separate group of individuals with schizophrenia who are prone to antisociality may serve to reduce the social stigma attached to schizophrenia in general, which is significantly amplified by sensational (albeit rare) cases of violence perpetuated by schizophrenia individuals.

“This stigma – which often leads to denial of services and programmatic funding – arguably constitutes a grave social injustice against individuals with schizophrenia who are not violent; and does little to advance the cause of those who are.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009




a.. Clin Psychol Rev 2009; Advance online publication