Unravelling the Heterogeneous Nature of Schizophrenia-Spectrum Disorders: a Cluster Analysis

Coman, Ruxandra (2024) Unravelling the Heterogeneous Nature of Schizophrenia-Spectrum Disorders: a Cluster Analysis. Master thesis, Psychology.

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Abstract

Background. Significant cognitive heterogeneity exists within the schizophrenia-spectrum disorders (SSD), with several cognitive subgroups characterized by more homogeneous cognitive profiles. Current knowledge on cognition in SSD stems from studies focusing on specific disorder stages, while the heterogeneous nature of the disorder as a whole has received less attention. Additionally, the link with clinical and functional outcomes is still unclear. This study aimed to: (1) identify cognitive clusters in a large and diagnostically heterogeneous sample of SSD patients using a clustering approach and compare them to healthy controls (HCs); and (2) determine whether emergent clusters differ in terms of clinical and functional outcomes. Methods. 573 SSD patients and 40 HCs were included. Ward’s hierarchical cluster analysis with k-means verification was performed using cognitive scores based on the Brief Assessment of Cognition in Schizophrenia (BACS). Cognitive clusters were compared both between clusters and to HCs and, subsequently, linked to clinical and functional outcomes. Results. Three distinct cognitive clusters emerged: a relatively preserved cluster (n = 209), a moderately impaired cluster (n = 199), and a severely impaired cluster (n = 163). The cognitive clusters significantly differed in educational attainment, parental educational attainment, cognition, symptom severity, and global functioning. Overall, the severely impaired cluster experienced the worst symptom severity and the lowest general functioning. Conclusions. Current findings provide further evidence for cognitive heterogeneity across all SSD diagnostic stages, suggesting that grouping patients along a cognitive continuum may offer crucial information about prognosis and for the development of new treatment strategies. Keywords: schizophrenia-spectrum disorders, cognitive impairment, hierarchical cluster analysis, cognitive clusters

Item Type:	Thesis (Master)
Supervisor name:	Pijnenborg, G.H.M.
Degree programme:	Psychology
Differentiation route:	Clinical Neuropsychology (CN) [Master Psychology]
Date Deposited:	13 Aug 2024 07:26
Last Modified:	13 Aug 2024 07:26
URI:	http://gmwpublic.studenttheses.ub.rug.nl/id/eprint/4249

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