Improving the understanding of the link between cognition and functional capacity in schizophrenia and bipolar disorder

Raeanne C. Moore; Alexandrea L. Harmell; Philip D. Harvey; Christopher R. Bowie; Colin A. Depp; Ann E. Pulver; John A. McGrath; Thomas L. Patterson; Veronica Cardenas; Paula Wolyniec; Mary H. Thornquist; James R. Luke; Barton W. Palmer; Dilip V. Jeste; Brent T. Mausbach

doi:10.1016/j.schres.2015.09.017

Improving the understanding of the link between cognition and functional capacity in schizophrenia and bipolar disorder

Raeanne C. Moore, Alexandrea L. Harmell, Philip D. Harvey, Christopher R. Bowie, Colin A. Depp, Ann E. Pulver, John A. McGrath, Thomas L. Patterson, Veronica Cardenas, Paula Wolyniec, Mary H. Thornquist, James R. Luke, Barton W. Palmer, Dilip V. Jeste, Brent T. Mausbach

School of Medicine

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Objective: Deficits in cognitive functioning are related to functional disability in people with serious mental illness. Measures of functional capacity are commonly used as a proxy for functional disabilities for cognitive remediation programs, and robust linear relationships between functional capacity and cognitive deficits are frequently observed. This study aimed to determine whether a curvilinear relationship better approximates the association between cognitive functioning and functional capacity. Method: Two independent samples were studied. Study 1: participants with schizophrenia (n = 435) and bipolar disorder (n = 390) aged 18-83 completed a neuropsychological battery and a performance-based measure of functional capacity. Study 2: 205 participants with schizophrenia (age range = 39-72) completed a brief neuropsychological screening battery and a performance-based measure of functional capacity. For both studies, linear and quadratic curve estimations were conducted with cognitive performance predicting functional capacity scores. Results: Significant linear and quadratic trends were observed for both studies. Study 1: in both the schizophrenia and bipolar participants, when cognitive composite z-scores were > 0 (indicating normal to above normal performance), cognition was not related to functional capacity. Study 2: when neuropsychological screening battery z-scores were >- 1 (indicating low average to average performance), cognition was not related to functional capacity. Conclusions: These results illustrate that in cognitively normal adults with serious mental illness, the relationship between cognitive function and functional capacity is relatively weak. These findings may aid clinicians and researchers determine who may optimally benefit from cognitive remediation programs, with greater benefits possibly being achieved for individuals with cognitive deficits relative to individuals with normal cognition.

Original language	English (US)
Pages (from-to)	121-127
Number of pages	7
Journal	Schizophrenia Research
Volume	169
Issue number	1-3
DOIs	https://doi.org/10.1016/j.schres.2015.09.017
State	Published - Dec 1 2015

Keywords

Cognitive remediation
Disability
Functional capacity
Functioning
Neuropsychological assessment
Serious mental illness

ASJC Scopus subject areas

Psychiatry and Mental health
Biological Psychiatry

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10.1016/j.schres.2015.09.017

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Moore, R. C., Harmell, A. L., Harvey, P. D., Bowie, C. R., Depp, C. A., Pulver, A. E., McGrath, J. A., Patterson, T. L., Cardenas, V., Wolyniec, P., Thornquist, M. H., Luke, J. R., Palmer, B. W., Jeste, D. V., & Mausbach, B. T. (2015). Improving the understanding of the link between cognition and functional capacity in schizophrenia and bipolar disorder. Schizophrenia Research, 169(1-3), 121-127. https://doi.org/10.1016/j.schres.2015.09.017

Moore, RC, Harmell, AL, Harvey, PD, Bowie, CR, Depp, CA, Pulver, AE, McGrath, JA, Patterson, TL, Cardenas, V, Wolyniec, P, Thornquist, MH, Luke, JR, Palmer, BW, Jeste, DV & Mausbach, BT 2015, 'Improving the understanding of the link between cognition and functional capacity in schizophrenia and bipolar disorder', Schizophrenia Research, vol. 169, no. 1-3, pp. 121-127. https://doi.org/10.1016/j.schres.2015.09.017

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title = "Improving the understanding of the link between cognition and functional capacity in schizophrenia and bipolar disorder",

abstract = "Objective: Deficits in cognitive functioning are related to functional disability in people with serious mental illness. Measures of functional capacity are commonly used as a proxy for functional disabilities for cognitive remediation programs, and robust linear relationships between functional capacity and cognitive deficits are frequently observed. This study aimed to determine whether a curvilinear relationship better approximates the association between cognitive functioning and functional capacity. Method: Two independent samples were studied. Study 1: participants with schizophrenia (n = 435) and bipolar disorder (n = 390) aged 18-83 completed a neuropsychological battery and a performance-based measure of functional capacity. Study 2: 205 participants with schizophrenia (age range = 39-72) completed a brief neuropsychological screening battery and a performance-based measure of functional capacity. For both studies, linear and quadratic curve estimations were conducted with cognitive performance predicting functional capacity scores. Results: Significant linear and quadratic trends were observed for both studies. Study 1: in both the schizophrenia and bipolar participants, when cognitive composite z-scores were > 0 (indicating normal to above normal performance), cognition was not related to functional capacity. Study 2: when neuropsychological screening battery z-scores were >- 1 (indicating low average to average performance), cognition was not related to functional capacity. Conclusions: These results illustrate that in cognitively normal adults with serious mental illness, the relationship between cognitive function and functional capacity is relatively weak. These findings may aid clinicians and researchers determine who may optimally benefit from cognitive remediation programs, with greater benefits possibly being achieved for individuals with cognitive deficits relative to individuals with normal cognition.",

keywords = "Cognitive remediation, Disability, Functional capacity, Functioning, Neuropsychological assessment, Serious mental illness",

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year = "2015",

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doi = "10.1016/j.schres.2015.09.017",

language = "English (US)",

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AU - Moore, Raeanne C.

AU - Harmell, Alexandrea L.

AU - Harvey, Philip D.

AU - Bowie, Christopher R.

AU - Depp, Colin A.

AU - Pulver, Ann E.

AU - McGrath, John A.

AU - Patterson, Thomas L.

AU - Cardenas, Veronica

AU - Wolyniec, Paula

AU - Thornquist, Mary H.

AU - Luke, James R.

AU - Palmer, Barton W.

AU - Jeste, Dilip V.

AU - Mausbach, Brent T.

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Objective: Deficits in cognitive functioning are related to functional disability in people with serious mental illness. Measures of functional capacity are commonly used as a proxy for functional disabilities for cognitive remediation programs, and robust linear relationships between functional capacity and cognitive deficits are frequently observed. This study aimed to determine whether a curvilinear relationship better approximates the association between cognitive functioning and functional capacity. Method: Two independent samples were studied. Study 1: participants with schizophrenia (n = 435) and bipolar disorder (n = 390) aged 18-83 completed a neuropsychological battery and a performance-based measure of functional capacity. Study 2: 205 participants with schizophrenia (age range = 39-72) completed a brief neuropsychological screening battery and a performance-based measure of functional capacity. For both studies, linear and quadratic curve estimations were conducted with cognitive performance predicting functional capacity scores. Results: Significant linear and quadratic trends were observed for both studies. Study 1: in both the schizophrenia and bipolar participants, when cognitive composite z-scores were > 0 (indicating normal to above normal performance), cognition was not related to functional capacity. Study 2: when neuropsychological screening battery z-scores were >- 1 (indicating low average to average performance), cognition was not related to functional capacity. Conclusions: These results illustrate that in cognitively normal adults with serious mental illness, the relationship between cognitive function and functional capacity is relatively weak. These findings may aid clinicians and researchers determine who may optimally benefit from cognitive remediation programs, with greater benefits possibly being achieved for individuals with cognitive deficits relative to individuals with normal cognition.

AB - Objective: Deficits in cognitive functioning are related to functional disability in people with serious mental illness. Measures of functional capacity are commonly used as a proxy for functional disabilities for cognitive remediation programs, and robust linear relationships between functional capacity and cognitive deficits are frequently observed. This study aimed to determine whether a curvilinear relationship better approximates the association between cognitive functioning and functional capacity. Method: Two independent samples were studied. Study 1: participants with schizophrenia (n = 435) and bipolar disorder (n = 390) aged 18-83 completed a neuropsychological battery and a performance-based measure of functional capacity. Study 2: 205 participants with schizophrenia (age range = 39-72) completed a brief neuropsychological screening battery and a performance-based measure of functional capacity. For both studies, linear and quadratic curve estimations were conducted with cognitive performance predicting functional capacity scores. Results: Significant linear and quadratic trends were observed for both studies. Study 1: in both the schizophrenia and bipolar participants, when cognitive composite z-scores were > 0 (indicating normal to above normal performance), cognition was not related to functional capacity. Study 2: when neuropsychological screening battery z-scores were >- 1 (indicating low average to average performance), cognition was not related to functional capacity. Conclusions: These results illustrate that in cognitively normal adults with serious mental illness, the relationship between cognitive function and functional capacity is relatively weak. These findings may aid clinicians and researchers determine who may optimally benefit from cognitive remediation programs, with greater benefits possibly being achieved for individuals with cognitive deficits relative to individuals with normal cognition.

KW - Cognitive remediation

KW - Disability

KW - Functional capacity

KW - Functioning

KW - Neuropsychological assessment

KW - Serious mental illness

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Improving the understanding of the link between cognition and functional capacity in schizophrenia and bipolar disorder

Abstract

Keywords

ASJC Scopus subject areas

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