Cognitive Subtyping in Schizophrenia: A Latent Profile Analysis.

Journal Article (Journal Article)

Cognitive dysfunction is a core feature of schizophrenia. The subtyping of cognitive performance in schizophrenia may aid the refinement of disease heterogeneity. The literature on cognitive subtyping in schizophrenia, however, is limited by variable methodologies and neuropsychological tasks, lack of validation, and paucity of studies examining longitudinal stability of profiles. It is also unclear if cognitive profiles represent a single linear severity continuum or unique cognitive subtypes. Cognitive performance measured with the Brief Assessment of Cognition in Schizophrenia was analyzed in schizophrenia patients (n = 767). Healthy controls (n = 1012) were included as reference group. Latent profile analysis was performed in a schizophrenia discovery cohort (n = 659) and replicated in an independent cohort (n = 108). Longitudinal stability of cognitive profiles was evaluated with latent transition analysis in a 10-week follow-up cohort. Confirmatory factor analysis (CFA) was carried out to investigate if cognitive profiles represent a unidimensional structure. A 4-profile solution was obtained from the discovery cohort and replicated in an independent cohort. It comprised of a "less-impaired" cognitive subtype, 2 subtypes with "intermediate cognitive impairment" differentiated by executive function performance, and a "globally impaired" cognitive subtype. This solution showed relative stability across time. CFA revealed that cognitive profiles are better explained by distinct meaningful profiles than a severity linear continuum. Associations between profiles and negative symptoms were observed. The subtyping of schizophrenia patients based on cognitive performance and its associations with symptomatology may aid phenotype refinement, mapping of specific biological mechanisms, and tailored clinical treatments.

Full Text

Duke Authors

Cited Authors

  • Lim, K; Smucny, J; Barch, DM; Lam, M; Keefe, RSE; Lee, J

Published Date

  • April 29, 2021

Published In

Volume / Issue

  • 47 / 3

Start / End Page

  • 712 - 721

PubMed ID

  • 33098300

Pubmed Central ID

  • PMC8084446

Electronic International Standard Serial Number (EISSN)

  • 1745-1701

Digital Object Identifier (DOI)

  • 10.1093/schbul/sbaa157


  • eng

Conference Location

  • United States