Differential cognitive and clinical improvements in Schizophrenia and bipolar disorder following hospitalization: A comparative analysis based on the Clock Drawing Test.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Bipolar Disorder*/psychology ; Bipolar Disorder*/physiopathology ; Bipolar Disorder*/therapy ; Schizophrenia*/physiopathology ; Schizophrenia*/therapy ; Cognition*; Humans ; Male ; Female ; Adult ; Middle Aged ; Hospitalization ; Cross-Sectional Studies ; Aged ; Iran ; Young Adult ; Neuropsychological Tests ; Psychiatric Status Rating Scales

Competing Interests: The authors declare that no competing and financial interests exist.
Background: Schizophrenia (SCZ) and bipolar disorder with psychotic features (BDP) are psychiatric disorders with significant impact on affected individuals. However, research comparing cognitive impairments between these groups is limited. This study aimed to evaluate the changes in cognitive function based on the Clock Drawing Test (CDT) among hospitalized SCZ and BDP patients and its association with positive and negative symptoms.
Methods: This cross-sectional study enrolled 84 Iranian patients (42 SCZ, 42 BDP, 51 male and 33 female) aged 42.85 (±11.51), ranging from 20 to 65 years old, from two psychiatric hospitals in Iran. The Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression (CGI) scale and CDT were administered during the admission and discharge of patients. Within-group and between-group changes were analyzed using paired t-tests for pre-post comparisons and multiple regression was used to assess predictive factors of changes in cognitive and symptom changes.
Results: Both groups showed cognitive and clinical improvements at discharge, but changes were more pronounced in the BDP group for CDT, PANSS-positive symptoms, and CGI. However, PANSS-negative symptoms improved more in SCZ patients. No correlations existed between changes in CDT and positive and negative symptoms in either of the groups.
Conclusion: While both groups exhibited cognitive and clinical improvements following hospitalization, patients with SCZ showed relatively less improvement in the CDT compared to those with BDP. These findings suggest that cognitive recovery may follow a different trajectory in SCZ, independent of changes in positive and negative symptoms but related to the initial cognitive profile. However, given that the CDT is a screening tool rather than a comprehensive cognitive assessment, these results should be interpreted with caution. Future research should incorporate broader neurocognitive assessments to better understand the cognitive trajectories of these populations.
(Copyright: © 2025 Pirani et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

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Date Created: 20250708 Date Completed: 20250708 Latest Revision: 20250710

20250710

PMC12237019

10.1371/journal.pone.0325537

40627645