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Brown HE, Hart KL, Snapper LA, et al. Impairment in delay discounting in schizophrenia and schizoaffective disorder but not primary mood disorders. NPJ Schizophr. 2018;4(1):9doi: 10.1038/s41537-018-0050-z.
Brown, H. E., Hart, K. L., Snapper, L. A., Roffman, J. L., & Perlis, R. H. (2018). Impairment in delay discounting in schizophrenia and schizoaffective disorder but not primary mood disorders. NPJ schizophrenia, 4(1), 9. https://doi.org/10.1038/s41537-018-0050-z
Brown, Hannah E, et al. "Impairment in delay discounting in schizophrenia and schizoaffective disorder but not primary mood disorders." NPJ schizophrenia vol. 4,1 (2018): 9. doi: https://doi.org/10.1038/s41537-018-0050-z
Brown HE, Hart KL, Snapper LA, Roffman JL, Perlis RH. Impairment in delay discounting in schizophrenia and schizoaffective disorder but not primary mood disorders. NPJ Schizophr. 2018 May 28;4(1):9. doi: 10.1038/s41537-018-0050-z. PMID: 29808011; PMCID: PMC5972152.
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NPJ Schizophr. 2018 May 28;4(1):9. doi: 10.1038/s41537-018-0050-z.

Impairment in delay discounting in schizophrenia and schizoaffective disorder but not primary mood disorders.

NPJ schizophrenia

Hannah E Brown, Kamber L Hart, Leslie A Snapper, Joshua L Roffman, Roy H Perlis

Affiliations

  1. Department of Psychiatry, Center for Quantitative Health, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. [email protected].
  2. Schizophrenia Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA. [email protected].
  3. Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. [email protected].
  4. Department of Psychiatry, Center for Quantitative Health, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  5. Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  6. Schizophrenia Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA.

PMID: 29808011 PMCID: PMC5972152 DOI: 10.1038/s41537-018-0050-z

Abstract

A measure of planning and impulse control, the delay-discounting (DD) task estimates the extent to which an individual decreases the perceived value of a reward as the reward is delayed. We examined cross-disorder performance between healthy controls (n = 88), individuals with bipolar disorder (n = 23), major depressive disorder (n = 43), and primary psychotic disorders (schizophrenia and schizoaffective disorder; n = 51) on the DD task (using a $10 delayed larger reward), as well as the interaction of DD scores with other symptom domains (cognition, psychosis, and affect). We found that individuals with schizophrenia and schizoaffective disorder display significantly greater rates of discounting compared to healthy controls, while individuals with a primary mood disorder do not differ from healthy controls after adjustment for IQ. Further, impairment in working memory is associated with higher discounting rates among individuals with schizophrenia and schizoaffective disorder, but cognitive dysfunction alone does not account for the extent of impairment in DD. Taken together, these results suggest an impaired ability to plan for the future and make adaptive decisions that are specific to individuals with psychotic disorders, and likely related to adverse functional outcomes. More generally, this work demonstrates the presence of variation in impulsivity across major psychiatric illnesses, supporting the use of a trans-diagnostic perspective.

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