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Schizophrenia patients with high intelligence: A clinically distinct sub-type of schizophrenia?

Published online by Cambridge University Press:  15 April 2020

E. Černis ,
E. Vassos ,
G. Brébion ,
P.J. McKenna ,
R.M. Murray ,
A.S. David  and
J.H. MacCabe
E. Černis*
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, Box P063, De Crespigny Park, London, United Kingdom, SE5 8AF
E. Vassos
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, Box P063, De Crespigny Park, London, United Kingdom, SE5 8AF
G. Brébion
Affiliation:
Unit of Research and Development, Parc Sanitari Sant Joan de Déu and CIBERSAM, Barcelona, Spain
P.J. McKenna
Affiliation:
Benito Menni CASM, and CIBERSAM, Barcelona, Spain
R.M. Murray
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, Box P063, De Crespigny Park, London, United Kingdom, SE5 8AF
A.S. David
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, Box P063, De Crespigny Park, London, United Kingdom, SE5 8AF
J.H. MacCabe
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, Box P063, De Crespigny Park, London, United Kingdom, SE5 8AF
*
⁎Corresponding author at: University of Oxford Institute of Clinical Psychology Training, Isis Education Centre, Warneford Hospital, Oxford, OX3 7JX. Tel.: +44 779 205 1130. E-mail address:Emma.cernis@hmc.ox.ac.uk (E. Černis).
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Abstract

Background

Schizophrenia patients are typically found to have low IQ both pre- and post-onset, in comparison to the general population. However, a subgroup of patients displays above average IQ pre-onset. The nature of these patients’ illness and its relationship to typical schizophrenia is not well understood. The current study sought to investigate the symptom profile of high-IQ schizophrenia patients.

Methods

We identified 29 schizophrenia patients of exceptionally high pre-morbid intelligence (mean estimated pre-morbid intelligence quotient (IQ) of 120), of whom around half also showed minimal decline (less than 10 IQ points) from their estimated pre-morbid IQ. We compared their symptom scores (SAPS, SANS, OPCRIT, MADRS, GAF, SAI-E) with a comparison group of schizophrenia patients of typical IQ using multinomial logistic regression.

Results

The patients with very high pre-morbid IQ had significantly lower scores on negative and disorganised symptoms than typical patients (RRR = 0.019; 95% CI = 0.001, 0.675, P = 0.030), and showed better global functioning and insight (RRR = 1.082; 95% CI = 1.020, 1.148; P = 0.009). Those with a minimal post-onset IQ decline also showed higher levels of manic symptoms (RRR = 8.213; 95% CI = 1.042, 64.750, P = 0.046).

Conclusions

These findings provide evidence for the existence of a high-IQ variant of schizophrenia that is associated with markedly fewer negative symptoms than typical schizophrenia, and lends support to the idea of a psychosis spectrum or continuum over boundaried diagnostic categories.

Keywords

SchizophreniaPsychosisIQCognitive functionSuperphrenia
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 5 , July 2015 , pp. 628 - 632
Copyright
Copyright © Elsevier Masson SAS 2015

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