Factor structures of the neurocognitive assessments and familial analysis in first-episode schizophrenia patients, their relatives and controls

Abstract

Objectives: Schizophrenia patients have a wide range of cognitive deficits. To explore the structure of these deficits and index their psychometric properties in order to define the major separable factors, exploratory factor analysis (EFA) was performed on a series of neuropsychological test results in a sample of Han Chinese first-episode schizophrenia patients, their relatives and controls without mental illness.

Methods: The factors derived from the composite sample were tested with confirmatory factor analysis (CFA) in each of the subsamples. The heritability of each factor was estimated by using the mixed linear model in order to determine whether the common factor scores describe the familiarity of the data.

Results: A six-factor model of general mental activity, sort and shift, attention and anti-interference, logical memory, reasoning and problem-solving/executive function, and visual reproduction were extracted and confirmed on EFA and CFA. There was a hierarchy in cognitive performance deficits in relatives depending on their relatedness to probands. Patients performed more poorly than siblings/offspring in general mental activity, sort and shift, attention and anti-interference, logical memory, planning and problem-solving, but not in visual reproduction. The logical memory domain was found to be significantly heritable (h²=0.34), and reasoning and problem-solving had a marginal heritability of around 0.19.

Conclusions: Generalized cognitive deficit accounts for the majority of the overall variance of cognitive deficits in schizophrenia. Estimates of heritability were modest. The present results also support the hypothesis that neurocognitive deficits of schizophrenia are familial and could serve as endophenotypes, especially logical memory, which is the most heritable.

Key words::

• heritability
• neurocognitive factor structures
• schizophrenia

Acknowledgements

We acknowledge Xiehe Liu, Yingcheng Wang, Jinhua Sun, Jing Yao for their assistance in data collection. This work was partly funded by National Nature Science Foundation of China (30530300 and 30125014, TL), the National Basic Research Program of China (973 Program 2007CB512301, TL), NARSAD Independent Investigator Award (TL), NARSAD Young Investigator Award (EV), the Wellcome Trust (International Collaborative award to TL, DAC and XL), and the State Scholarship Foundation of Greece (EV).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.