Decision making, working memory and executive functions in schizophrenia

Introduction: Cognitive decline is one of the core symptoms of schizophrenia. Deficits of decision making, working memory and executive functions are among the most prominent, and lead to poorer functional outcome. The identification of a specific decision-making style and its relationship with deficits of working memory and executive function may contribute to the improvement of therapeutic strategies aimed at patients' functional capabilities. Material and methods: Thirty individuals with schizophrenia and 30 healthy controls underwent an assessment of decision-making and executive functions. Decision-making was assessed by means of the Iowa Gambling Task. Working memory and executive functions were assessed by means of the Wisconsin Card Sorting Test and Trail Making Test. Results: Individuals with schizophrenia made significantly more choices from the decks involving frequent penalties, and from deck A', involving both high and frequent penalties, compared to healthy participants, in the Iowa Gambling Task. No between-group differences in the number of choices from both decks involving high losses were observed. Patients were also outperformed in tasks assessing the executive functions. No correlations between the tasks assessing decision-making and executive functions were observed. Conclusions: Individuals with schizophrenia present a specific decision-making style, accompanied by deficits of working memory and executive functions. Addressing these areas should be a focus in therapeutic strategies for individuals with schizophrenia.