Baseline Neurocognitive Deficits in the CATIE Schizophrenia Trial
Abstract
Neurocognition is moderately to severely impaired in patients with schizophrenia. However, the factor structure of the various neurocognitive deficits, the relationship with symptoms and other variables, and the minimum amount of testing required to determine an adequate composite score has not been determined in typical patients with schizophrenia. An 'all-comer' approach to cognition is needed, as provided by the baseline assessment of an unprecedented number of patients in the CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) schizophrenia trial. From academic sites and treatment providers representative of the community, 1493 patients with chronic schizophrenia were entered into the study, including those with medical comorbidity and substance abuse. Eleven neurocognitive tests were administered, resulting in 24 individual scores reduced to nine neurocognitive outcome measures, five domain scores and a composite score. Despite minimal screening procedures, 91.2% of patients provided meaningful neurocognitive data. Exploratory principal components analysis yielded one factor accounting for 45% of the test variance. Confirmatory factor analysis showed that a single-factor model comprised of five domain scores was the best fit. The correlations among the factors were medium to high, and scores on individual factors were very highly correlated with the single composite score. Neurocognitive deficits were modestly correlated with negative symptom severity (r=0.13-0.27), but correlations with positive symptom severity were near zero (r<0.08). Even in an 'all-comer' clinical trial, neurocognitive deficits can be assessed in the overwhelming majority of patients, and the severity of impairment is similar to meta-analytic estimates. Multiple analyses suggested that a broad cognitive deficit characterizes this sample. These deficits are modestly related to negative symptoms and essentially independent of positive symptom severity.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The larger the study of the factorial structure of cognitive performance, the more likely it is that a single, global ability factor arises from factor analyses.
“The larger the study of the factorial structure of cognitive performance, the more likely it is that a single, global ability factor arises from factor analyses. 66 - 67”
From Domains of cognition and their assessment (2019) · cites this paper as [67]
Cites
Alternative Ways of Assessing Model Fit
Browne, M. W., & Cudeck, R. (1992) · Sociological Methods & Research · doi:10.1177/0049124192021002005 · Cited by 27,200 · see citing works
The Positive and Negative Syndrome Scale (PANSS) for schizophrenia.
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987) · Schizophrenia Bulletin · doi:10.1093/schbul/13.2.261 · Cited by 21,378 · see citing works
Testing Structural Equation Models.
Mueller, C. W., Bollen, K. A., & Long, J. S. (1994) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2074955 · Cited by 14,211 · see citing works
The Handbook of Social Psychology
Gravatt, A. E., Lindzey, G. E., & Aronson, F. (1969) · The Family Coordinator · doi:10.2307/582242 · Cited by 12,518 · see citing works
Testing Structural Equation Models.
Clogg, C. C., Bollen, K. A., & Long, J. S. (1995) · Social Forces · doi:10.2307/2580595 · Cited by 8,244 · see citing works
Wechsler Intelligence Scale for Children
Miles-Mason, E. (2018) · Sage eBooks · doi:10.4135/9781483392271.n537 · Cited by 4,133 · see citing works
Wechsler Adult Intelligence Scale-III
Ryan, J. J., & Lopez, S. J. (2001) · Springer eBooks · doi:10.1007/978-1-4615-1185-4_2 · Cited by 3,680 · see citing works
What are the functional consequences of neurocognitive deficits in schizophrenia?
(1996) · American Journal of Psychiatry · doi:10.1176/ajp.153.3.321 · Cited by 3,516 · see citing works
Psychological Assessment Resources
Abidin, R. R. (1995) · Medical Entomology and Zoology · Cited by 3,140 · see citing works
Green, M. F., Kern, R. S., Braff, D. L., & Mintz, J. (2000) · Schizophrenia Bulletin · doi:10.1093/oxfordjournals.schbul.a033430 · Cited by 2,999 · see citing works
Self-citationNeurocognitive deficit in schizophrenia: A quantitative review of the evidence.
Heinrichs, R. W., & Zakzanis, K. K. (1998) · Neuropsychology · doi:10.1037/0894-4105.12.3.426 · Cited by 2,798 · see citing works
Neurocognitive deficit in schizophrenia: A quantitative review of the evidence.
Heinrichs, R. W., & Zakzanis, K. K. (1998) · Neuropsychology · doi:10.1037//0894-4105.12.3.426 · Cited by 2,791 · see citing works
(1998) · Cited by 2,713 · see citing works
Wechsler Adult Intelligence Scale
(2007) · Sage eBooks · doi:10.4135/9781412952644.n478 · Cited by 2,017 · see citing works
Keefe, R. (2004) · Schizophrenia Research · doi:10.1016/j.schres.2003.09.011 · Cited by 1,573 · see citing works
Identification of separable cognitive factors in schizophrenia
Nuechterlein, K. H., Barch, D. M., Gold, J. M., Goldberg, T. E., Green, M. F., & Heaton, R. K. (2004) · Schizophrenia Research · doi:10.1016/j.schres.2004.09.007 · Cited by 1,304 · see citing works
Self-citationNeuropsychological Function in Schizophrenia
Saykin, A. J. (1991) · Archives of General Psychiatry · doi:10.1001/archpsyc.1991.01810310036007 · Cited by 1,160 · see citing works
A Handbook of Social Psychology.
Pigors, P., & Murchison, C. (1936) · American Sociological Review · doi:10.2307/2084503 · Cited by 978 · see citing works
Green, M. F., Nuechterlein, K. H., Gold, J. M., Barch, D. M., Cohen, J., Essock, S., Fenton, W. S., Frese, F., Goldberg, T. E., Heaton, R. K., et al. (2004) · Biological Psychiatry · doi:10.1016/j.biopsych.2004.06.023 · Cited by 919 · see citing works
Self-citationNeuropsychology of First-Episode Schizophrenia: Initial Characterization and Clinical Correlates
Bilder, R. M., Goldman, R. S., Robinson, D. G., Reiter, G., Bell, L., Bates, J. A., Pappadopulos, E. A., Willson, D. F., Alvir, J., Woerner, M. G., et al. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.4.549 · Cited by 906 · see citing works
Self-citationAuditory Working Memory and Wisconsin Card Sorting Test Performance in Schizophrenia
Gold, J. M. (1997) · Archives of General Psychiatry · doi:10.1001/archpsyc.1997.01830140071013 · Cited by 823 · see citing works
Self-citationA National Study of Violent Behavior in Persons With Schizophrenia
Swanson, J. W., Swartz, M. S., Dorn, R. A. V., Elbogen, E. B., Wagner, H. R., Rosenheck, R. A., Stroup, T. S., McEvoy, J. P., & Lieberman, J. A. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.5.490 · Cited by 799 · see citing works
Self-citationImpaired Attention, Genetics, and the Pathophysiology of Schizophrenia
Cornblatt, B. A., & Keilp, J. G. (1994) · Schizophrenia Bulletin · doi:10.1093/schbul/20.1.31 · Cited by 666 · see citing works
Stroup, T., Mcevoy, J., Swartz, M., Byerly, M., Glick, I., Cañive, J., McGee, M., Simpson, G., Stevens, M., & Lieberman, J. (2003) · Schizophrenia bulletin · doi:10.1093/oxfordjournals.schbul.a006986 · Cited by 647 · see citing works
Self-citationStability and Course of Neuropsychological Deficits in Schizophrenia
Heaton, R. K., Gladsjo, J. A., Palmer, B. W., Kuck, J., Marcotte, T. D., & Jeste, D. V. (2001) · Archives of General Psychiatry · doi:10.1001/archpsyc.58.1.24 · Cited by 618 · see citing works
Self-citationStudies of Cognitive Change in Patients With Schizophrenia Following Novel Antipsychotic Treatment
Harvey, P. D., & Keefe, R. S. E. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.2.176 · Cited by 617 · see citing works
Self-citationWoodward, N. D., Purdon, S. E., Meltzer, H. Y., & Zald, D. H. (2005) · The International Journal of Neuropsychopharmacology · doi:10.1017/s146114570500516x · Cited by 605 · see citing works
Self-citationKerr, S., & Neale, J. M. (1993) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.102.2.312 · Cited by 585 · see citing works
Kerr, S. L., & Neale, J. M. (1993) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.102.2.312 · Cited by 584 · see citing works
Disordered Thought in Schizophrenia
Chapman, L. J., & Chapman, J. P. (1975) · Medical Entomology and Zoology · Cited by 478 · see citing works
Generalized Cognitive Deficits in Schizophrenia
Mohamed, S., Paulsen, J. S., OʼLeary, D. S., Arndt, S. V., & Andreasen, N. C. (1999) · Archives of General Psychiatry · doi:10.1001/archpsyc.56.8.749 · Cited by 432 · see citing works
Defining a cognitive function decrement in schizophrenia
Keefe, R. S. E., Eesley, C. E., & Poe, M. P. (2005) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.01.003 · Cited by 389 · see citing works
Self-citationDisordered thought (Schizophrenia)
Sheahan, J. (1973) · Springer eBooks · doi:10.1007/978-94-011-7138-0_11 · Cited by 368 · see citing works
Goldberg, T. E., Gold, J. M., Greenberg, R. D., Griffin, S. J., Schulz, S. C., Pickar, D., Kleinman, J. E., & Weinberger, D. R. (1993) · American Journal of Psychiatry · doi:10.1176/ajp.150.9.1355 · Cited by 307 · see citing works
Self-citationMemory impairment in schizophrenia: its extent, affiliations and neuropsychological character
Tamlyn, D., McKenna, P. J., Mortimer, A. M., Lund, C. E., Hammond, S., & Baddeley, A. (1992) · Psychological Medicine · doi:10.1017/s0033291700032773 · Cited by 302 · see citing works
Cognitive functioning and positive and negative symptoms in schizophrenia
Addington, J., Addington, D. E., & Maticka‐Tyndale, E. (1991) · Schizophrenia Research · doi:10.1016/0920-9964(91)90039-t · Cited by 284 · see citing works
What Are the Right Targets for Psychopharmacology?
Hyman, S. E., & Fenton, W. S. (2003) · Science · doi:10.1126/science.1077141 · Cited by 282 · see citing works
General and specific cognitive deficits in schizophrenia
Dickinson, D., Iannone, V. N., Wilk, C. M., & Gold, J. M. (2004) · Biological Psychiatry · doi:10.1016/j.biopsych.2003.12.010 · Cited by 253 · see citing works
Self-citationLongitudinal study of symptoms and cognitive function in chronic schizophrenia
Hughes, C., Kumari, V., Soni, W., Das, M., Binneman, B., Drozd, S., O'Neil, S., Mathew, V. M., & Sharma, T. (2002) · Schizophrenia Research · doi:10.1016/s0920-9964(01)00393-0 · Cited by 214 · see citing works
Green, A. I., Tohen, M. F., Hamer, R. M., Strakowski, S. M., Lieberman, J. A., Glick, I. D., & Clark, W. S. (2003) · Schizophrenia Research · doi:10.1016/j.schres.2003.08.001 · Cited by 195 · see citing works
Self-citationNeuropsychological function in schizophrenia
Nyman, H. (2002) · European Psychiatry · doi:10.1016/s0924-9338(02)80803-3 · Cited by 166 · see citing works
Relations of Symptoms to Cognitive Deficits in Schizophrenia
Strauss, M. E. (1993) · Schizophrenia Bulletin · doi:10.1093/schbul/19.2.215 · Cited by 163 · see citing works
No, It Is Not Possible to Be Schizophrenic Yet Neuropsychologically Normal.
Wilk, C. M., Gold, J. M., McMahon, R. P., Humber, K., Iannone, V. N., & Buchanan, R. W. (2005) · Neuropsychology · doi:10.1037/0894-4105.19.6.778 · Cited by 156 · see citing works
Self-citationHarvey, P. D., Green, M. F., McGurk, S. R., & Meltzer, H. Y. (2003) · Psychopharmacology · doi:10.1007/s00213-002-1342-5 · Cited by 154 · see citing works
Self-citationAttentional impairments in deficit and nondeficit forms of schizophrenia
Buchanan, R. W., Strauss, M. E., Breier, A. F., Kirkpatrick, B., & Carpenter, W. T. (1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.3.363 · Cited by 153 · see citing works
Tulsky, D. S., & Price, L. R. (2003) · Psychological Assessment · doi:10.1037/1040-3590.15.2.149 · Cited by 131 · see citing works
Wilk, C. M. (2003) · Schizophrenia Research · doi:10.1016/j.schres.2003.10.009 · Cited by 131 · see citing works
Harvey, P. D., Lombardi, J., Leibman, M., WHITE, L. E., Parrella, M. J., Powchik, P., & Davidson, M. (1996) · Schizophrenia Research · doi:10.1016/s0920-9964(96)00075-8 · Cited by 130 · see citing works
Self-citationPandey, G. N., & Dwivedi, Y. (2005) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145704004936 · Cited by 118 · see citing works
Cannabis use prior to first onset psychosis predicts spared neurocognition at 10-year follow-up
Stirling, J., Lewis, S. W., Hopkins, R., et al. (2004) · Schizophrenia Research · doi:10.1016/j.schres.2004.10.006 · Cited by 116 · see citing works
Keefe, R. S. E., Mohs, R. C., Bilder, R. M., Harvey, P. D., Green, M. F., Meltzer, H. Y., Gold, J. M., & Sano, M. (2003) · Schizophrenia Bulletin · doi:10.1093/oxfordjournals.schbul.a006990 · Cited by 110 · see citing works
Self-citationDickinson, D., Ragland, J. D., Calkins, M. E., Gold, J. M., & Gur, R. C. (2006) · Schizophrenia Research · doi:10.1016/j.schres.2006.03.003 · Cited by 105 · see citing works
Self-citationGladsjo, J. A., McAdams, L. A., Palmer, B. W., Moore, D. J., Jeste, D. V., & Heaton, R. K. (2004) · Schizophrenia Bulletin · doi:10.1093/oxfordjournals.schbul.a007127 · Cited by 104 · see citing works
Self-citationHarvey, P. D., SIU, C. O., & Romano, S. J. (2004) · Psychopharmacology · doi:10.1007/s00213-003-1652-2 · Cited by 83 · see citing works
Self-citationA brief cognitive assessment for use with schizophrenia patients in community clinics
Velligan, D. I., DiCocco, M., Bow-Thomas, C. C., Cadle, C., Glahn, D. C., Miller, A. L., Biggs, M. M., Shores‐Wilson, K., McKenzie, C. A., & Crismon, M. L. (2004) · Schizophrenia Research · doi:10.1016/j.schres.2004.02.027 · Cited by 73 · see citing works
Cognitive Impairment in Schizophrenia and Implications of Atypical Neuroleptic Treatment
Harvey, P. D., & Keefe, R. S. E. (1997) · CNS Spectrums · doi:10.1017/s1092852900005034 · Cited by 72 · see citing works
Self-citationBowie, C. R. (2005) · Schizophrenia Bulletin · doi:10.1093/jschbul/sbi001 · Cited by 61 · see citing works
Short- and Long-Term Spatial Delayed Response Performance Across the Lifespan
Lyons-Warren, A. M., Lillie, R., & Hershey, T. G. (2004) · Developmental Neuropsychology · doi:10.1207/s15326942dn2603_1 · Cited by 55 · see citing works
Brandt, J. (1991) · PsycTESTS Dataset · doi:10.1037/t49859-000 · Cited by 30 · see citing works
Slade, E. P., Salkever, D. S., Rosenheck, R. A., Swanson, J. W., Swartz, M. S., Shern, D. L., Gallucci, G., Harding, C. M., Palmer, L. A., & Russo, P. A. (2005) · Psychiatric Services · doi:10.1176/appi.ps.56.8.960 · Cited by 13 · see citing works
Self-citationSharma, T., & Bilder, R. M. (2004) · European Neuropsychopharmacology · doi:10.1016/s0924-977x(04)80573-x · Cited by 12 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Fett, A.-K. J., Viechtbauer, W., Dominguez, M.-D.-G., Penn, D. L., van Os, J., & Krabbendam, L. (2011) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2010.07.001 · Cited by 1,833 · see citing works
Administration and interpretation of the Trail Making Test
Bowie, C. R., & Harvey, P. D. (2006) · Nature Protocols · doi:10.1038/nprot.2006.390 · Cited by 1,418 · see citing works
Self-citationDomains of cognition and their assessment
Harvey, P. D. (2019) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2019.21.3/pharvey · Cited by 695 · see citing works
Self-citationHow should DSM-V criteria for schizophrenia include cognitive impairment?
Keefe, R. S. E., & Fenton, W. S. (2007) · Schizophrenia Bulletin · doi:10.1093/schbul/sbm046 · Cited by 394 · see citing works
Self-citationBentall, R. P., Rowse, G., Shryane, N., Kinderman, P., Howard, R., Blackwood, N., Moore, R., & Corcoran, R. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.1 · Cited by 295 · see citing works
Clinical predictors of therapeutic response to antipsychotics in schizophrenia
Carbon, M., & Correll, C. U. (2014) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2014.16.4/mcarbon · Cited by 257 · see citing works
Cognitive functioning in patients with affective disorders and schizophrenia: a meta-analysis
Stefanopoulou, E., Manoharan, A., Landau, S., Geddes, J. R., Goodwin, G., & Frangou, S. (2009) · International Review of Psychiatry · doi:10.1080/09540260902962149 · Cited by 141 · see citing works
McClay, J. L., Adkins, D. E., Åberg, K., Bukszár, J., Khachane, A. N., Keefe, R. S. E., Perkins, D. O., McEvoy, J. P., Stroup, T. S., Vann, R. E., et al. (2011) · Neuropsychopharmacology · doi:10.1038/npp.2010.193 · Cited by 124 · see citing works
Self-citationBudel, S., Padukkavidana, T., Liu, B. P., Feng, Z., Hu, F., Johnson, S., Lauren, J., Park, J. H., McGee, A. W., Liao, J., et al. (2008) · The Journal of Neuroscience · doi:10.1523/jneurosci.3828-08.2008 · Cited by 107 · see citing works
Acute serotonin and dopamine depletion improves attentional control: findings from the Stroop task
Scholes, K. E., Harrison, B. J., O'Neill, B. V., Leung, S., Croft, R. J., Pipingas, A., Phan, K. L., & Nathan, P. J. (2007) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301262 · Cited by 86 · see citing works
Cognitive Remediation in Schizophrenia
Kaneko, Y., & Keshavan, M. (2012) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2012.10.3.125 · Cited by 51 · see citing works
Harvey, P. D., Aslan, M., Du, M., Zhao, H., Siever, L. J., Pulver, A., Gaziano, J. M., & Concato, J. (2016) · Neuropsychology · doi:10.1037/neu0000245 · Cited by 42 · see citing works
Self-citationImplementation considerations for multisite clinical trials with cognitive neuroscience tasks
Keefe, R. S. E., & Harvey, P. D. (2007) · Schizophrenia Bulletin · doi:10.1093/schbul/sbn042 · Cited by 24 · see citing works
Wright, A. C., Davies, G., Fowler, D., & Greenwood, K. E. (2019) · Schizophrenia Bulletin · doi:10.1093/schbul/sby155 · Cited by 15 · see citing works
- Authors
- Keefe, R. S. E., Bilder, R. M., Harvey, P. D., Davis, S. M., Palmer, B. W., Gold, J. M., Meltzer, H. Y., Green, M. F., Miller, D. D., Canive, J. M., Adler, L. W., Manschreck, T. C., Swartz, M., Rosenheck, R., Perkins, D. O., Walker, T. M., Stroup, T. S., McEvoy, J. P., & Lieberman, J. A.
- Affiliations
- Duke University (US)
- University of California, Los Angeles (US)
- Icahn School of Medicine at Mount Sinai (US)
- University of California San Diego (US)
- Vanderbilt University Medical Center (US)
- University of Iowa (US)
- Clinical Insights (US)
- Harvard University (US)
- Duke Medical Center (US)
- Yale University (US)
- University of North Carolina at Chapel Hill (US)
- New York State Psychiatric Institute (US)
- Corresponding author
- Keefe, Richard S E
- ORCID
- Venue
- Neuropsychopharmacology
- Published
- 2006-04-19
- Volume
- 31
- Issue
- 9
- Pages
- 2033-2046
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- OpenAlex
- W1975586101
- Cited by
- 472
- References
- 61
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 7 · 2023: 6 · 2022: 18 · 2021: 16 · 2020: 18 · 2019: 21 · 2018: 20 · 2017: 28 · 2016: 20 · 2015: 31 · 2014: 33 · 2013: 32 · 2012: 34
- FWCI
- 24.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
- Keywords
- schizophrenia, neurocognitive impairment, CATIE trial, negative symptoms, positive symptoms, chronic schizophrenia, cognitive screening, substance abuse, comorbidities
- MeSH terms
- Adult, Cognition Disorders, Data Interpretation, Statistical, Female, Humans, Male, Memory, Neuropsychological Tests, Psychomotor Performance, Schizophrenic Psychology
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
