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A cognitive neuropsychological approach to the study of delusions in late-onset schizophrenia

Phillips, Mary L., Howard, R. and David, A. S. 1997. A cognitive neuropsychological approach to the study of delusions in late-onset schizophrenia. International Journal of Geriatric Psychiatry 12 (9) , pp. 892-901. 10.1002/(SICI)1099-1166(199709)12:9<892::AID-GPS657>3.0.CO;2-0

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OBJECTIVE: Hypotheses to explain delusion formation include distorted perceptual processing of meaningful stimuli (e.g. faces), abnormal reasoning, or a combination of both. The study investigated these hypotheses using standardized neuropsychological tests. DESIGN: A three-patient case-study, compared with a small group (n = 8) of age-matched normal control subjects. SETTING: Hospital in- and outpatients. Age-matched normal controls were from local residential homes. PATIENTS: Three subjects with late-onset schizophrenia, two currently deluded and one in remission. Both deluded subjects had persecutory beliefs. One had a delusion of misidentification. INTERVENTIONS: All subjects were administered standardized neuropsychological tests of facial processing and tests of verbal reasoning. MAIN OUTCOME MEASURES: The test scores of the three patients were compared with published normal values and the age-matched control data. RESULTS: The tests demonstrated impaired matching of unfamiliar faces in deluded subjects, particularly in the subject with delusional misidentification. Increasing the emotional content of logical reasoning problems had a significant effect on the deluded subjects' reasoning but not that of the normal controls. CONCLUSION: The findings suggest impaired visual processing plus abnormal reasoning in deluded subjects. However, these impairments are relatively subtle given the severity of psychiatric disorder in the patients studied.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Publisher: Wiley-Blackwell
ISSN: 0885-6230
Last Modified: 27 Nov 2015 13:30

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