Schizophrenia research. Cognition · 2026
Executive dysfunction and cognitive disorganization in schizophrenia: Case-control and cluster analyses of a Korean Wisconsin Card Sorting Test cohort.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kim Kyungwon, Lee Byung Dae, Lee Young Min, Moon Eunsoo, Suh Hwagyu, Kim Si Yul
Аннотация
OBJECTIVE: Executive dysfunction is a hallmark cognitive deficit in schizophrenia, yet phenotypic heterogeneity within the disorder complicates clinical translation. This study aimed to identify discrete executive profiles within a large Korean schizophrenia cohort using the Wisconsin Card Sorting Test (WCST) and to evaluate their clinical and functional correlates.
METHOD: We analyzed WCST performance in 276 individuals with schizophrenia and 361 healthy controls. A principal component analysis (PCA)-derived executive composite was validated against chart-reviewed clinical variables in a patient subset (n = 145). K-means cluster analysis was utilized to characterize cognitive heterogeneity, stratifying patients into distinct neurocognitive profiles.
RESULTS: Patients with schizophrenia exhibited severe, broad executive impairment compared to controls, particularly in total errors (Hedges' g = 2.268), categories achieved (g = 2.122), and conceptual-level responses (g = 1.751). Within the patient group, cluster analysis robustly identified three distinct executive profiles: mild/near-normal (n = 83), intermediate (n = 88), and severe (n = 105). While age was independently associated with the general executive dysfunction composite (β = 0.254, p = 0.004), conceptual disorganization showed a prominent, theoretically consistent trend-level association (β = 0.166,p = 0.065). Exploratory neurodevelopmental burden and mediation pathways did not show robust statistical signals.
CONCLUSIONS: Executive dysfunction in schizophrenia is characterized by reproducible, clinically interpretable sub-profiles rather than a uniform deficit. Stratifying patients into mild, intermediate, and severe executive clusters provides a practical framework for neurocognitive heterogeneity, which may facilitate target selection for individualized cognitive remediation and functional rehabilitation strategies.
METHOD: We analyzed WCST performance in 276 individuals with schizophrenia and 361 healthy controls. A principal component analysis (PCA)-derived executive composite was validated against chart-reviewed clinical variables in a patient subset (n = 145). K-means cluster analysis was utilized to characterize cognitive heterogeneity, stratifying patients into distinct neurocognitive profiles.
RESULTS: Patients with schizophrenia exhibited severe, broad executive impairment compared to controls, particularly in total errors (Hedges' g = 2.268), categories achieved (g = 2.122), and conceptual-level responses (g = 1.751). Within the patient group, cluster analysis robustly identified three distinct executive profiles: mild/near-normal (n = 83), intermediate (n = 88), and severe (n = 105). While age was independently associated with the general executive dysfunction composite (β = 0.254, p = 0.004), conceptual disorganization showed a prominent, theoretically consistent trend-level association (β = 0.166,p = 0.065). Exploratory neurodevelopmental burden and mediation pathways did not show robust statistical signals.
CONCLUSIONS: Executive dysfunction in schizophrenia is characterized by reproducible, clinically interpretable sub-profiles rather than a uniform deficit. Stratifying patients into mild, intermediate, and severe executive clusters provides a practical framework for neurocognitive heterogeneity, which may facilitate target selection for individualized cognitive remediation and functional rehabilitation strategies.