Stability and Course of Neuropsychological Deficits in Schizophrenia
Archives of General PsychiatryPublished 1 January 2001
Robert K. Heaton, Julie Akiko Gladsjo, Barton W. Palmer, Julia Kuck, Thomas D. Marcotte, Dilip V. Jeste
Citations615
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TL;DR
The schizophrenic group was neuropsychologically more impaired than the normal comparison subjects but showed comparable test-retest reliability and comparable neuropsychological stability over both short and long follow-up periods.
Abstract
Neuropsychological impairment in ambulatory persons with schizophrenia appears to remain stable, regardless of baseline characteristics and changes in clinical state. Our results may not be generalizable to the minority of institutionalized poor-outcome patients.
Keywords
MedicineArts and HumanitiesNeuroscience
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Choice Reviews OnlineA compendium of neuropsychological tests: administration, norms, and commentary
6,168 Citations1991
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