A six-factor model of cognition in schizophrenia and related psychotic disorders: relationships with clinical symptoms and functional capacity

Schizophr Bull. 2004;30(4):739-54. doi: 10.1093/oxfordjournals.schbul.a007127.

Abstract

Confirmatory factor analysis was used to examine a proposed factor structure of a comprehensive neuropsychological battery used to study patients with schizophrenia and related psychotic disorders (n = 209). An a priori six-factor model and five nested models were evaluated successively, using maximum likelihood confirmatory factor analysis. In all multifactor models, the factors were significantly intercorrelated. A six-factor model with two pairs of correlated errors fit the neuropsychological data significantly better than competing models with fewer factors. The six factors included verbal crystallized, attention/working memory, verbal episodic memory, speed of information processing, visual episodic memory, and reasoning/problem solving. Severity of negative symptoms was significantly associated with worse performance on attention/working memory and verbal crystallized factors, but positive symptoms, depression, and a summary measure of psychopathology were not significantly related to neuropsychological performance. Impairment on a performance-based measure of functional capacity was significantly related to all neuropsychological factors. A simultaneous confirmatory factor analysis using the original sample and a group of healthy subjects (n = 131) demonstrated that the six-factor model of cognition was generalizable and applied equally well to both groups.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antipsychotic Agents / therapeutic use
  • Brief Psychiatric Rating Scale
  • Cognition Disorders / diagnosis
  • Cognition Disorders / etiology*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Factor Analysis, Statistical
  • Female
  • Hospitalization
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / drug therapy
  • Psychotic Disorders / etiology*
  • Schizophrenia / complications*
  • Schizophrenia / diagnosis
  • Schizophrenia / rehabilitation
  • Severity of Illness Index

Substances

  • Antipsychotic Agents