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Title: Cognitive subtyping in schizophrenia : a latent profile analysis
Authors: Lim, Keane
Smucny, Jason
Barch, Deanna M.
Lam, Max
Keefe, Richard S. E.
Lee, Jimmy Chee Keong
Keywords: Science::General
Issue Date: 2021
Source: Lim, K., Smucny, J., Barch, D. M., Lam, M., Keefe, R. S. E. & Lee, J. C. K. (2021). Cognitive subtyping in schizophrenia : a latent profile analysis. Schizophrenia Bulletin, 47(3), 712-721.
Project: NMRC/TCR/003/2008
Journal: Schizophrenia Bulletin
Abstract: Cognitive dysfunction is a core feature of schizophrenia. The subtyping of cognitive performance in schizophrenia may aid the refinement of disease heterogeneity. The literature on cognitive subtyping in schizophrenia, however, is limited by variable methodologies and neuropsychological tasks, lack of validation, and paucity of studies examining longitudinal stability of profiles. It is also unclear if cognitive profiles represent a single linear severity continuum or unique cognitive subtypes. Cognitive performance measured with the Brief Assessment of Cognition in Schizophrenia was analyzed in schizophrenia patients (n = 767). Healthy controls (n = 1012) were included as reference group. Latent profile analysis was performed in a schizophrenia discovery cohort (n = 659) and replicated in an independent cohort (n = 108). Longitudinal stability of cognitive profiles was evaluated with latent transition analysis in a 10-week follow-up cohort. Confirmatory factor analysis (CFA) was carried out to investigate if cognitive profiles represent a unidimensional structure. A 4-profile solution was obtained from the discovery cohort and replicated in an independent cohort. It comprised of a "less-impaired" cognitive subtype, 2 subtypes with "intermediate cognitive impairment" differentiated by executive function performance, and a "globally impaired" cognitive subtype. This solution showed relative stability across time. CFA revealed that cognitive profiles are better explained by distinct meaningful profiles than a severity linear continuum. Associations between profiles and negative symptoms were observed. The subtyping of schizophrenia patients based on cognitive performance and its associations with symptomatology may aid phenotype refinement, mapping of specific biological mechanisms, and tailored clinical treatments.
ISSN: 0586-7614
DOI: 10.1093/schbul/sbaa157
Rights: © 2020 The Author(s). Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved.
Fulltext Permission: none
Fulltext Availability: No Fulltext
Appears in Collections:LKCMedicine Journal Articles

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