Dysexecutive Behavior in First-Episode Schizophrenia

Abstract

Background: Dysexecutive syndrome is a prominent and functionally significant cognitive feature of schizophrenia. This study assesses and correlates executive function (EF) deficits and dysexecutive behavior (DB) in first-episode schizophrenia (FES) patients and healthy participants. Methods: We evaluated 22 FES patients (aged 17–29 years, history of single episode of schizophrenia, treated with atypical antipsychotics) and 20 controls matched for gender, age, and education. EF was evaluated using the Modified Six Elements Test (MSET), Modified Wisconsin Card Sorting Test (M-WCST), and Frontal Assessment Battery (FAB). DB was evaluated using the Dysexecutive Questionnaire (DEX) and Behavioral Dysexecutive Syndrome Inventory (BDSI). Results: FES patients had marked dysexecutive behaviors and executive function impairments as compared to controls. Our findings suggest that executive function scores on standardized neuropsychological tests may be ecologically valid predictors of dysexecutive behavior. Conclusion: DB is common during first-episode schizophrenia and may be a primary impairment throughout disease progression. The present results inform clinical practice by providing insight into first-episode schizophrenia specific features of dysexecutive behavior. Understanding the associations between executive function tests and dysexecutive behaviors helps to explain the social adjustment disorders associated with schizophrenia. This knowledge may be used to improve diagnostic and therapeutic tools; for example, clarifying the implications of specific DEX and BDSI dimensions could increase the efficacy of individual or familial psychotherapy and cognitive rehabilitation interventions.