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Sự thiếu hụt nhận thức trong tâm thần phân liệt bao gồm Cuối premorbid thấp hơn chỉ số IQ (Hình 3,18) 13, cũng như thâm hụt circumscribed hơn, ví dụ trong bộ nhớ và chức năng điều hành (hình 3,1914 và 3,2015). Đây là một tính năng Hầu như Chắc chắn chính của rối loạn này. | SCORE ON WISCONSIN CARD SORT TEST Figure 3.20 Wisconsin card sort test WCST in monozygotic twins discordant for schizophrenia. The WCST is a measure of executive function. In twins discordant for schizophrenia performance on the WCST is uniformly impaired in the affected twin. Data from Goldberg TE Torrey EF Bigelow LB et al. Genetic risk of neuropsychological impairment in schizophrenia a study of monozygotic twins discordant and concordant for the disorder. Schizophr Res 1995 17 77-84 The cognitive deficits seen in schizophrenia include lower premorbid IQ Figure 3.18 13 as well as more circumscribed deficits for example in memory and executive function Figures 3.1914 and 3.2015 . These are almost certainly a primary feature of the disorder. Some neuropsychological deficits are present long before the onset of schizophrenia. Two large cohort studies from the UK have supported the idea that the deficits of schizophrenia may be apparent early in life with evidence of impaired educational test performance and avoidant social behavior Figure 3.21 16. Childhood schizoid personality traits may reflect deficits in cognition and in social behavior that are part of the disease process itself. Abnormalities of social behavior movement and posture have also been reported for example in studies based on old home movies of affected and unaffected siblings . The antecedents of schizophrenia may therefore become identifiable long before the clinical onset of the illness. TRAJECTORY OF PREMORBID IMPAIRMENT Figure 3.21 The study of large birth cohorts provides a powerful tool for investigating risk factors in schizophrenia. In the 1946 UK birth cohort16 risk factors for later schizophrenia included problems at play few friends inappropriate emotional expression anxiety impaired intellectual function and odd movements. Figure reproduced with permission from Jones P Rodgers B Murray R Marmot M. Child development risk factors for adult schizophrenia in the British 1946 birth cohort.
