Executive function tests in early-onset psychosis: which one to choose?

Area of Science:

• Neuropsychology
• Psychiatry
• Cognitive Science

Background:

• Executive functioning deficits are prominent in schizophrenia, particularly in early-onset schizophrenia (EOS).
• Cognitive assessment tools validated for adult-onset schizophrenia (AOS) may not be optimal for EOS due to differing cognitive profiles.
• The MATRICS Consensus Cognitive Battery, including NAB Mazes, is used for assessing executive functions in AOS treatment studies.

Purpose of the Study:

• To compare the executive functioning assessment capabilities of NAB Mazes with the D-KEFS Color Word Interference Test (Stroop) and Wisconsin Card Sorting Test (WCST) in adolescents with schizophrenia spectrum disorders.
• To determine the sensitivity and discriminating power of these tests in an early-onset schizophrenia population.

Main Methods:

• A cohort of 31 adolescents with schizophrenia spectrum disorders and 66 healthy controls were administered the NAB Mazes, Stroop, and WCST.
• Performance differences between patient and control groups were analyzed for each measure.

Main Results:

• All three tests demonstrated significant discriminating power between patients and controls.
• Patients performed 0.8-1.5 standard deviations below controls.
• The Stroop test was the most sensitive measure, followed by NAB Mazes, and then WCST.

Conclusions:

• NAB Mazes is a capable tool for differentiating executive functioning deficits in adolescents with schizophrenia spectrum disorders from healthy controls.
• While Stroop is more sensitive, NAB Mazes is a sensible choice for clinical settings assessing EOS.
• Stroop can serve as a complementary measure for more detailed executive functioning evaluations in EOS.