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KMID : 0605720170230010023
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Journal of the Korean Society of Biological Therapies in Psychiatry
2017 Volume.23 No. 1 p.23 ~ p.32
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Clinical Implications of the First 4 Trials on the Wisconsin Card Sorting Test in Patients with Schizophrenia
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Kim Kyung-Won
Lee Byung-Dae
Park Je-Min
Moon Eun-Soo
Lee Young-Min
Jeong Hee-Jeong
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Abstract
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Objectives：This study evaluated consecutive response patterns on the first four trials of Wisconsin card sorting test(WCST), not just correct % of each card, in patients with deficit and non-deficit schizophrenia.
Methods：The subjects were 145 outpatients with schizophrenia diagnosed by DSM-IV. The deficit(n=37) and non-deficit(n=108) subgroups of the patients were evaluated by retrospective chart review based on the Schedule for the Deficit Syndrome(SDS). Given assign code ‘1’ to the correct responses and ‘0’ to the wrong responses of the WCST, the patients who responded as 1111, 0111, or 0011 on the first four trials were considered as good performers (n=33) and who responded other ways, such as 1010, 0101, etc. were poor performers(n=112).
Results：Patients with deficit schizophrenia had lower outcomes in % correct, categories achieved and conceptual level responses than patients with non-deficit schizophrenia. According to the first trials of WCST, poor performers had lower outcomes in all classical indices which were number of trials, % correct, categories achieved and conceptual level responses. Significantly more patients in the deficit group were classified as poor performers on the first four trials. The poor performers failed to chase up the good performers during the first ten trials. The sensitivity and specificity of poor/good performance criteria predicting deficit or non-deficit schizophrenia was 89.2% and 26.9%, respectively.
Conclusion：The response patterns of the first four trials in WCST could be an index reflecting the whole WCST performance and predict deficit symptoms better than non-deficit ones in schizophrenia.
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KEYWORD
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Schizophrenia, Cognitive dysfunction, Neuropsychological test
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