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¿Qué significado neuropsicológico tiene la perseveración de los pacientes con esquizofrenia paranoide en el Wisconsin Card Sorting Test?

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Author(s): Cortés , José Francisco | Galindo y Villa, Gabriela | Salvador , Judith

Journal: Salud Mental
ISSN 0185-3325

Volume: 23;
Issue: 4;
Start page: 28;
Date: 2000;
Original page

Keywords: Neuropsychology | problem solving | cognition | verbal thought.

ABSTRACT
Various investigations indicate that perseveration is a common neuropsychological sign of schizophrenia, resulting from the lack of cognitive flexibility, secondary to the dysfunction of the frontal lobe. However, from a semiological point of view, perseveration may have different neuropsychological meanings. In most of the results obtained by means of the application of the Wisconsin Card Sorting Test (WCST) this sign has been interpreted as a direct consequence of the incapability of patients for making a fast comparative change between the different concepts and for adopting diferent perspectives about a concept without analyzing other possible causes of failure in the fulfillment of this task. The purpose of this work was that of analyzing in detail the different dimensions of the WCST for evaluating, in a semiologic way, the nature of the perseverative answers. This instrument was the applied to a group of 30 paranoid schizophrenic patients, compared to 30 healthy subjects, paired by age, sex and academic education. The group was compared by means of simple ANOVA in the three WCST dimensions, and two matrixes of partial correlations, controlled by the number of asseys used for analyzing the relation between these variables; the correlation coefficients obtained for each group were compared by means of Fisher¿s Z contrasts. Finally, the answering trains (positive and negative) were analyzed by means of Grant¿s G2 test for tridimensional contingence tables. Results suggest that schizophrenic patients have important deficiencies for confronting this paradigm, and actually commit a significantly higher number of perseverative answers. However, perseveration in these patients, more than reflecting their lack of cognitive flexibility, seem to relate to deffects in the abstraction and comprehension of the problem.

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