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The global cognitive impairment in schizophrenia: Consistent over decades and around the world
Open accessAbstract
Objective Schizophrenia results in cognitive impairments as well as positive, negative, and disorganized symptomatology. The present study examines the extent to which these cognitive deficits are generalized across domains, potential moderator variables, and whether the pattern of cognitive findings reported in schizophrenia has remained consistent over time and across cultural and geographic variation.Method Relevant publications from 2006 to 2011 were identified through keyword searches in PubMed and an examination of reference lists. Studies were included if they (1) compared the cognitive performance of adult schizophrenia patients and healthy controls, (2) based schizophrenia diagnoses on contemporary diagnostic criteria, (3) reported information sufficient to permit effect size calculation, (4) were reported in English, and (5) reported data for neuropsychological tests falling into at least 3 distinct cognitive domains. A set of 100 non-overlapping studies was identified, and effect sizes (Hedge's g) were calculated for each cognitive variable.Results Consistent with earlier analyses, patients with schizophrenia scored significantly lower than controls across all cognitive tests and domains (grand mean effect size, g=-1.03). Patients showed somewhat larger impairments in the domains of processing speed (g=-1.25) and episodic memory (g=-1.23). Our results also showed few inconsistencies when grouped by geographic region.Conclusions The present study extends findings from 1980 to 2006 of a substantial, generalized cognitive impairment in schizophrenia, demonstrating that this finding has remained robust over time despite changes in assessment instruments and alterations in diagnostic criteria, and that it manifests similarly in different regions of the world despite linguistic and cultural differences.
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“However, previous studies assessed either voluntary imitation [7][8][9][10][25][26][27][28][29][30][31] or automatic imitation of emotional stimuli 12,13,32,33 while not controlling for the cognitive, motoric, and/or emotional deficits associated with the disorder.”
From Enhanced Automatic Action Imitation and Intact Imitation-Inhibition in Schizophrenia (2019) · cites this paper as [32]
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“voluntary tasks are (to varying degrees) taxing on a range of cognitive processes that are known to be impaired in schizophrenia, 32 but which are not specifically tied to imitation.”
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“However, previous studies assessed either voluntary imitation [7][8][9][10][25][26][27][28][29][30][31] or automatic imitation of emotional stimuli 12,13,32,33 while not controlling for the cognitive, motoric, and/or emotional deficits associated with the disorder.”
From Enhanced Automatic Action Imitation and Intact Imitation-Inhibition in Schizophrenia (2019) · cites this paper as [32]
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“Indeed, overimitation is sometimes seen in schizophrenia in the form of symptoms like echolalia or echopraxia.31,32”
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Attention and memory deficits in schizophrenia: the role of symptoms of depression.
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“Theory of Mind” and Executive Functioning in Forensic Patients with Schizophrenia
Majorek, K., Wolfkühler, W., Küper, C., Saimeh, N., Juckel, G., & Brüne, M. (2009) · Journal of Forensic Sciences · doi:10.1111/j.1556-4029.2008.00966.x · Cited by 39
Genetic overlap between schizophrenia and selective components of executive function
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A Randomized, Double-Blind, Placebo-Controlled Trial of Fluvoxamine in Patients With Schizophrenia
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Cognitive functions in bipolar affective disorder and schizophrenia: Comparison
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Cerebellar deficits in schizophrenia are associated with executive dysfuntion
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Executive functions and cognitive deficits in schizophrenia
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Relations Among Intelligence, Executive Function, and P300 Event Related Potentials in Schizophrenia
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Course of cognitive functioning during the stabilization phase of schizophrenia
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Cross-national cognitive assessment in schizophrenia clinical trials: a feasibility study
Harvey, P. D., Fortuny, L. A. I., Vester-Blokland, E., & Smedt, G. D. (2002) · Schizophrenia Research · doi:10.1016/s0920-9964(02)00153-6 · Cited by 31
Elevated noise power in gamma band related to negative symptoms and memory deficit in schizophrenia
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Sustained Attention and Working Memory Deficits Follow a Familial Pattern in Schizophrenia
Giakoumaki, S. G., Roussos, P., Pallis, E. G., & Bitsios, P. (2011) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acr060 · Cited by 30
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An investigation of 3 neurocognitive subtypes in schizophrenia
Ammari, N., Heinrichs, R. W., & Miles, A. A. (2010) · Schizophrenia Research · doi:10.1016/j.schres.2010.04.014 · Cited by 28
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Declarative and nondeclarative memory in schizophrenia: What is impaired? What is spared?
Kern, R. S., Hartzell, A., Izaguirre, B., & Hamilton, A. H. (2010) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803391003671166 · Cited by 27
Activity-Based Prospective Memory in Schizophrenia
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Birth Weight and Neurocognition in Schizophrenia Spectrum Disorders
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Relevance of neurocognitive deficits for functional outcome in schizophrenia
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Neuropsychological Functioning in Schizophrenia Patients with First-Rank (Passivity) Symptoms
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Cognitive functions in stable schizophrenia & euthymic state of bipolar disorder.
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Has the Generalized Deficit Become the Generalized Criticism?
Green, M. F., Horan, W. P., & Sugar, C. A. (2012) · Schizophrenia Bulletin · doi:10.1093/schbul/sbs146 · Cited by 23
Duration of Illness, Regional Brain Morphology and Neurocognitive Correlates in Schizophrenia
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Confabulation in schizophrenia: A neuropsychological study
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Empirical validation of competing definitions of schizophrenia
Cuesta, M. J., Peralta, V., & Zarzuela, A. (2007) · Schizophrenia Research · doi:10.1016/j.schres.2007.06.021 · Cited by 15
Cognitive deficits in nonaffective functional psychoses: A study in the Democratic Republic of Congo
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The impact of monetary reward on memory in schizophrenia spectrum disorder.
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Declarative memory and WCST-64 performance in subjects with schizophrenia and healthy controls
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Evidence of some strategic preservation of episodic learning in patients with schizophrenia
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Metadata
- Authors
- Schaefer, J., Giangrande, E., Weinberger, D. R., & Dickinson, D.
- Affiliations
- National Institutes of Health (US)
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 150
- Issue
- 1
- Pages
- 42-50
- ISSN
- 0920-9964 (ISSN-L)
- PMC
- PMC4196267
- OpenAlex
- W2104347649
- Cited by
- 605
- References
- 138
- Citations by year
- 2026: 33 · 2025: 44 · 2024: 40 · 2023: 46 · 2022: 46 · 2021: 53 · 2020: 53 · 2019: 61 · 2018: 52 · 2017: 60 · 2016: 41 · 2015: 50 · 2014: 21 · 2013: 4
- FWCI
- 5.15
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99 MH999999)
- National Institute of Mental Health (ZIAMH002712)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- schizophrenia, cognitive impairment
- MeSH terms
- Cognition Disorders, Humans, Neuropsychological Tests, Schizophrenia, Schizophrenic Psychology, Meta-Analysis as Topic, Databases, Bibliographic
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