The Utility of the Wisconsin Card Sorting Test in Differential Diagnosis of Cognitive Disorders in Iranian Psychiatric Patients and Healthy Subjects
,
Abstract
Objective: The Wisconsin Test Card Sorting Test (WCST) is a neuropsychological test that has been suggested as a more specific test for frontal lobes dysfunctions. This study was designed to determine whether WCST is able to differentiate between Iranian psychiatric patients with cognitive disorders and normal subjects, and whether WCST scores are related to severity of symptoms in depressive and schizophrenic patients.
Method: Participants were four groups: schizophrenics with positive symptoms (n=25); schizophrenics with negative symptoms (n=25); major depressives (n=25); and normal subjects (n=25). All subjects were tested individually using WCST. To analyze the data, various descriptive statistics, ANOVA, t-test and multiple regression analysis were used.
Results: Regarding the number of categories (P<0.001) and the rate of perseverative errors (P<0.01), according to the results, the normal subjects performed significantly better than patient groups on W CST, although the differences between patient groups were not significant. Our results also showed that greater positive or depressive symptoms were not associated with poorer scores on WCST performance. Only the level of severity of negative symptoms predicted scores on per severative errors.
Conclusion: It is concluded that WCST can differentiate Iranian psychiatric patients with cognitive disorders from normal subjects, but it is not able to clearly differentiate schizophrenic patients with negative symptoms from those with positive symptoms and depressives. Only severity of negative symptoms affects WCST performance
Bujoreanu IS, Willis WG. Developmental and neuropsychological perspectives on the Wisconsin Card Sorting Test in children. Dev Neuropsychol 2008; 33: 584-600.
Cianchetti C, Corona S, Foscoliano M, Contu D, Sannio-Fancello G. Modified Wisconsin Card Sorting Test (MCST, MWCST): normative data in children 4-13 years old, according to classical and new types of scoring. Clin Neuropsychol 2007; 21: 456-478.
Hashimoto K, Uruma G, Abo M. Activation of the prefrontal cortex during the wisconsin card sorting test (Keio Version) as measured by two-channel near-infrared spectroscopy in patients with traumatic brain injury. Eur Neurol 2008; 59: 24-30.
Su CY, Lin YH, Kwan AL, Guo NW. Construct validity of the Wisconsin Card Sorting Test-64 in patients with stroke. Clin Neuropsychol 2008; 22: 273-287.
Gamboz N, Borella E, Brandimonte MA. The role of switching, inhibition and working memory in older adults' performance in the Wisconsin Card Sorting Test. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2009; 16: 260-284.
Chase-Carmichael CA, Ris MD, Weber AM and Schefft BK. Neurologic validity of the Wisconsin Card Sorting Test with a pediatric population. Clin Neuropsychol 1999; 13: 405-413.
Berg EA. A simple objective technique for measuring flexibility in thinking. J Gen Psychol 1948; 39: 15-22.
Heaton RK, Chelune GJ, Talley JL, Kay GG, Curtiss G. Wisconsin Card Sorting Test manual: Revised and expanded. Odessa, FL: Psychological Assessment Resources; 1993.
Heaton RK. Wisconsin Card Sorting Test Manual. Odessa, FL: Psychological Assessment Resources, Inc; 1981.
Lezak MD. Neuropsychological Assessment, 3rd ed. New York: Oxford University Press, 1995.
Dunbar K, Sussman D. Toward a cognitive account of frontal lobe function: Simulating frontal lobe deficits in normal subjects. In: Grafman G, Holyaok KJ, eds. Structure and Functions of the Human Prefrontal Cortex (Annals of the New York Academy of Sciences; Vol. 769). New York: New York Academy of Sciences, 1995.
Berman KF, Ostrem JL, Randolph C, Gold J, Goldberg TE, Coppola R, et al. Physiological activation of a cortical network during performance of the Wisconsin Card Sorting Test: a positron emission tomography study. Neuropsychologia 1995; 33: 1027-1046.
Grafman J, Holyoak KJ, Boller F. Structures and Functions of the Human Prefrontal Cortex. New York: New York Academy of Sciences; 1995.
Bonilha L, Molnar C, Horner MD, Anderson B, Forster L, George MS, et al. Neurocognitive deficits and prefrontal cortical atrophy in patients with schizophrenia. Schizophr Res 2008; 101: 142-151.
Rusch N, Spoletini I, Wilke M, Bria P, Di Paola M, Di Iulio F, et al. Prefrontal-thalamic-cerebellar gray matter networks and executive functioning in schizophrenia. Schizophr Res 2007; 93: 79-89.
Crow TJ. Two syndromes in schizophrenia? Trends Neurosci; 1982; 5: 351-354.
Xu-hui F, Xiang W, Shu-qiao Y, Xu-hui F. A Comparative Study of Neurocognitive Function in Schizophrenics with Positive and Negative Symptoms. Chinese Journal of Clinical Psychology 2006; 14: 31-32.
Szulc A, Galinska B, Tarasow E, Walecki J, Dzienis W, Kubas B, et al. [Clinical and neuropsychological correlates of proton magnetic resonance spectroscopy detected metabolites in brains of first-episode and schizophrenic patients]. Psychiatr Pol 2003; 37: 977-988.
Erberk Ö, Yüks N, Boratav C, Karak S. Assessment of frontal lobe functions in schizophrenia, depression and alcohol dependence. Klinik Psikofarmakoloji Bülteni 2005; 15: 93-103.
Lesser IM, Miller BL, Boone KB, Hill-Gutierrez E, Mehringer CM, Wong K, et al. Brain injury and cognitive function in late-onset psychotic depression. J Neuropsychiatry Clin Neurosci 1991; 3: 33-40.
Frodl T, Schaub A, Banac S, Charypar M, Jager M, Kummler P, et al. Reduced hippocampal volume correlates with executive dysfunctioning in major depression. J Psychiatry Neurosci 2006; 31: 316-323.
Cavedini P, Ferri S, Scarone S, Bellodi L. Frontal lobe dysfunction in obsessive-compulsive disorder and major depression: a clinical-neuropsychological study. Psychiatry Res 1998; 78: 21-28.
Coffey CE, Wilkinson WE, Weiner RD, Parashos IA, Djang WT, Webb MC, et al. Quantitative cerebral anatomy in depression. A controlled magnetic resonance imaging study. Arch Gen Psychiatry 1993; 50: 7-16.
Morrison-Stewart SL, Williamson PC, Corning WC, Kutcher SP, Snow WG, Merskey H. Frontal and non-frontal lobe neuropsychological test performance and clinical symptomatology in schizophrenia. Psychol Med 1992; 22: 353-359.
Yunlong T, Yizhuang Z, Ying Q. Frontal lobe executive function on patients with major depression and OCD. Chinese Mental Health Journal 2003; 17: 617-619.
Moritz S, Birkner C, Kloss M, Jahn H, Hand I, Haasen C, et al. Executive functioning in obsessive-compulsive disorder, unipolar depression, and schizophrenia. Arch Clin Neuropsychol 2002; 17: 477-483.
Fagerlund B, Pagsberg AK, Hemmingsen RP. Cognitive deficits and levels of IQ in adolescent onset schizophrenia and other psychotic disorders. Schizophr Res 2006; 85: 30-39.
Martin DJ, Oren Z, Boone K. Major depressives' and dysthmics' performance on the Wisconsin Card Sorting Test. J Clin Psychol 1991; 47: 684-690.
Ilonen T, Leinonen K, Wallenius E, Karlsson H, Taiminen T, Salokangas R, Lauerma H, Tuimala P. Impaired Wisconsin Card Sorting Test performance in first-episode severe depression. Nordic Journal of Psychiatry 2000; 54: 275-280.
Haghshenas H. Construction and standardization of reading word test as a verbal intelligence scale (MHK). Iranian Journal of Psychiatric and Clinical Psychology 2000; 16(21): 52-59.
Andreasen NC, Olsen S. Negative v positive schizophrenia. Definition and validation. Arch Gen Psychiatry 1982; 39: 789-794.
Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory–II. San Antonio,TX: Psychological Corporation; 1996.
Zade Mohammadi A, Heydari M, Majd-Teimori M. [Studying the Effect of Music Therapy on Negative and Positive Symptoms in Psychotic Patients]. Psychology Journal 2001; 3: 231-249.
Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory--Second edition: BDI-II-PERSIAN. Depress Anxiety 2005; 21: 185-192.
Dabson KS, Mohamad-khani P. Psychometric characteristics of Beck Depression inventory –II in patients with major depression disorder. Journal of rehabilitation 1386; 8: 82-88.
Martino DJ, Bucay D, Butman JT, Allegri RF. Neuropsychological frontal impairments and negative symptoms in schizophrenia. Psychiatry Res 2007; 152: 121-128.
Thurston-Snoha BJ, Lewine RR. Intact Wisconsin Card Sorting Test performance: implications for the role of executive function in schizophrenia. Br J Clin Psychol 2007; 46: 361-369.
Ou H, Chen P, Zhang N, Chen T, Shi W, Wu X, Guan C. Cognitive dysfunction in depression. Chinese Mental Health Journal 2001; 15: 340-341.
Zhening L, Junxiong Z, Xiaozhang C. Wisconsin Card Sorting Test and Continue Performance Test in Depression. Chinese Mental Health Journal 2003; 17: 690-692.
Anu E. Castaneda AE, Tuulio-Henriksson A, Marttunen M, Suvisaari J, Lönnqvist JA. Review on cognitive impairments in depressive and anxiety disorders with a focus on young adults. Journal of Affective Disorders 2008; 106(1-2): 1-27.
Castaneda AE, Tuulio-Henriksson A, Marttunen M, Suvisaari J, Lonnqvist J. A review on cognitive impairments in depressive and anxiety disorders with a focus on young adults. J Affect Disord 2008; 106: 1-27.
Marazziti D, Consoli G, Picchetti M, Carlini M, Faravelli L. Cognitive impairment in major depression. Eur J Pharmacol 2010; 626: 83-86.
Moreno-Iniguez M, Ortuno F, Bonelli RM, Millan M, Soutullo CA, Cervera-Enguiz S. Perseverative error in schizophrenia: correlation with cortical blood flow by SPECT. Actas Esp Psiquiatr 2007; 35: 20-28.
Demakis GJ. A meta-analytic review of the sensitivity of the Wisconsin Card Sorting Test to frontal and lateralized frontal brain damage. Neuropsychology 2003; 17: 255-264.
Franke P, Maier W, Hardt J, Frieboes R, Lichtermann D, Hain C. Assessment of frontal lobe functioning in schizophrenia and unipolar major depression. Psychopathology 1993; 26: 76-84.
Rempfer M, Hamera E, Brown C, Bothwell RJ. Learning proficiency on the Wisconsin Card Sorting Test in people with serious mental illness: what are the cognitive characteristics of good learners? Schizophr Res 2006; 87: 316-322.
| Files | ||
| Issue | Vol 6 No 3 (2011) | |
| Section | Articles | |
| Keywords | ||
| Cognition Depression Frontal lobe Schizophrenia | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
