Iowa Gambling Task in schizophrenia: A review and new data in patients with schizophrenia and co-occurring cannabis use disorders

Sevy, Serge; Burdick, Katherine E.; Visweswaraiah, Hema; Abdelmessih, Sherif; Lukin, Meredith; Yechiam, Eldad; Bechara, Antoine

doi:10.1016/j.schres.2007.01.005

« Previous Next »Schizophrenia Research
Volume 92, Issue 1 , Pages 74-84, May 2007

Iowa Gambling Task in schizophrenia: A review and new data in patients with schizophrenia and co-occurring cannabis use disorders

Serge Sevy
- Department of Psychiatry Research, Zucker Hillside Hospital, North-Shore-Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY, 11004, USA
- Corresponding author. Tel.: +1 718 470 8175; fax: +1 718 343 1659.
Katherine E. Burdick
- Department of Psychiatry Research, Zucker Hillside Hospital, North-Shore-Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY, 11004, USA
Hema Visweswaraiah
- Department of Psychiatry Research, Zucker Hillside Hospital, North-Shore-Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY, 11004, USA
Sherif Abdelmessih
- Department of Psychiatry Research, Zucker Hillside Hospital, North-Shore-Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY, 11004, USA
Meredith Lukin
- Department of Psychiatry Research, Zucker Hillside Hospital, North-Shore-Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY, 11004, USA
Eldad Yechiam
- Department of Industrial Engineering and Management — Technion Israel Institute of Technology, Haifa, 32000, Israel
Antoine Bechara
- Department of Neurology, Division of Cognitive Neuroscience, University of Iowa College of Medicine, Iowa City, IA, USA

Received 6 September 2006; received in revised form 11 January 2007; accepted 19 January 2007. published online 24 March 2007.

Abstract

Background

We reviewed previous studies comparing schizophrenia patients and healthy subjects for performance on the Iowa Gambling Task (IGT) (a laboratory task designed to measure emotion-based decision-making), and found mixed results. We hypothesize that deficits in IGT performance in schizophrenia may be more specifically related to concurrent substance use disorders. To test this hypothesis, we compared schizophrenia patients with (SCZ⁽⁺⁾) or without (SCZ⁽⁻⁾) cannabis use disorders, to healthy subjects, on measures of cognition and IGT performance.

Methods

A comprehensive battery of cognitive tests and the IGT were administered to three groups of subjects: (1) 13 subjects with DSM-IV diagnosis of schizophrenia and no concurrent substance use disorders (mean age: 28±12 (SD); 54% males); (2) 14 subjects with schizophrenia and concurrent cannabis use disorders (mean age: 29±9 (SD); 71% males); and (3) 20 healthy subjects (mean age 33±10 (SD); 60% males).

Results

Compared to the healthy group, both schizophrenia groups were cognitively more impaired, and did worse on IGT performance. There were no differences between SCZ⁽⁺⁾ and SCZ⁽⁻⁾ patients on most of the cognitive tests, and IGT performance.

Conclusions

Schizophrenia patients show widespread impairments in several cognitive domains and emotion-based decision-making. These results are consistent with the evidence that schizophrenia reflects a dorsolateral and orbitofrontal/ventromedial prefrontal cortex dysfunction. More intriguing, it appears that the concurrent abuse of cannabis has no compounding effects on cognition, as well as emotion/affect-based decision-making.

Keywords: Schizophrenia, Cannabis, Decision-making, Iowa Gambling Task, Cognition