Latent Profiles of Cognitive Control, Episodic Memory, and Visual Perception Across Psychiatric Disorders Reveal a Dimensional Structure

Jason Smucny, Ana Maria Iosif, Nicholas R. Eaton, Tyler A. Lesh, J. Daniel Ragland, Deanna M. Barch, James M. Gold, Milton E. Strauss, Angus W. MacDonald, Steven M. Silverstein, Cameron S. Carter

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Although meta-analyses suggest that schizophrenia (SZ) is associated with a more severe neurocognitive phenotype than mood disorders such as bipolar disorder, considerable between-subject heterogeneity exists in the phenotypic presentation of these deficits across mental illnesses. Indeed, it is unclear whether the processes that underlie cognitive dysfunction in these disorders are unique to each disease or represent a common neurobiological process that varies in severity. Here we used latent profile analysis (LPA) across 3 distinct cognitive domains (cognitive control, episodic memory, and visual integration; using data from the CNTRACS consortium) to identify distinct profiles of patients across psychotic illnesses. LPA was performed on a sample of 223 psychosis patients (59 with Type I bipolar disorder, 88 with SZ, and 76 with schizoaffective disorder). Seventy-three healthy control participants were included for comparison but were not included in sample LPA. Three latent profiles ("Low," "Moderate," and "High" ability) were identified as the underlying covariance across the 3 domains. The 3-profile solution provided highly similar fit to a single continuous factor extracted by confirmatory factor analysis, supporting a unidimensional structure. Diagnostic ratios did not significantly differ between profiles, suggesting that these profiles cross diagnostic boundaries (an exception being the Low ability profile, which had only one bipolar patient). Profile membership predicted Brief Psychiatric Rating Scale and Young Mania Rating Scale symptom severity as well as everyday communication skills independent of diagnosis. Biological, clinical and methodological implications of these findings are discussed.

Original languageEnglish (US)
Pages (from-to)154-162
Number of pages9
JournalSchizophrenia bulletin
Volume46
Issue number1
DOIs
StatePublished - Jan 4 2020

Bibliographical note

Funding Information:
This research was supported by National Institutes of Health (NIH) grants MH084840, MH084826, MH084828, MH084861, MH08482, MH059883, and MH114325.

Funding Information:
We thank the staff at each of the CNTRACS sites for their hard work and our subjects for their time, energy, and co-operation. J.D.R. has received research grants from the National Institutes of Health (NIH), the Brain & Behavior Research Foundation, the EJLB Foundation, and the Robert Wood Johnson Foundation. D.M.B. has received grants from the Brain & Behavior Research Foundation and the National Institutes of Health (NIH), and is a consultant for Pfizer, Amgen, Upsher-Smith and Takeda on studies related to the treatment of negative symptoms in schizophrenia. J.M.G. has received grants from National Institutes of Health (NIH), receives royalty payments from Brief Assessment of Cognition in Schizophrenia, and has acted as a consultant to Amgen, AstraZeneca, GlaxoSmithKline, Hoffman LaRoche, Merck, Pfizer, and Solvay. A.W.M. has received research grants from the National Institutes of Health (NIH) and the Brain & Behavior Research Foundation. S.M.S. has received research grants from the National Institutes of Mental Health (NIMH), The Brain & Behavior Research Foundation, the van Ameringen Foundation, the Jacob and Valeria Langaloth Foundation, the New England Research Institutes, the New York State Office of Mental Health, the New Jersey Division of Mental Health and Addiction Services, Janssen Pharmaceuticals, AstraZeneca, and Pfizer. CSC has received research grants from the National Institutes of Health (NIH), the Brain and Behavior Foundation, the Burroughs Wellcome foundation, GlaxoSmithKline, and the Robert Wood Johnson Foundation and has been an external consultant for Lilly, Merck, Pfizer, Roche, and Servier. The other authors have no conflicts of interest to report.

Publisher Copyright:
© 2019 The Author(s). Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved.

Keywords

  • bipolar disorder
  • cluster analysis
  • schizoaffective disorder
  • schizophrenia

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Multicenter Study

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