Validation of the cognitively normal range and below normal range subtypes in chronically hospitalized patients with schizophrenia

BACKGROUND: Many studies have found a substantial minority of patients whose performance puts them within the normal range of neuropsychological functioning. Recently, a study has seen the delineation of two neurocognitive subtypes of schizophrenia –‘cognitively normal range’ (CNR) and ‘below normal range’ (BNR) – based on neurocognitive performance across multiple domains. METHODS: The participants were from two studies that collected neurocognitive, psychopathology and social function data between 2008 and 2015. In total the complete data from one hundred and thirty one patients of Han Chinese ethnicity with schizophrenia were collected on 21 neurocognitive indexes (assessing the domains of processing speed, attention, working memory, verbal memory, visual memory, reasoning and problem solving and IQ). Fifty-five patients of the one hundred and thirty one participants received additional ratings on their psychopathology and social functions. An exploratory graphic analysis was conducted on the neurocognitive measures for the entire sample. Difference analyses were also performed according to the aims of the study using the Independent t test, Chi-square test, and Cohen's d effect size. RESULTS: Analyses revealed the existence of two patients subtypes. The post hoc tests showed that there were significant differences on all of their neurocognitive measures and on most of the psychopathology and social functions between the two subtypes. These two subtypes could be referred to as the CNR subtype and the BNR subtype respectively. CONCLUSIONS: There are neurocognitive subtypes of schizophrenia with differential illness characteristics comparable with the CNR and the BNR in patients of Han Chinese ethnicity with schizophrenia.