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In the present study, we compared cognitive impairments in schizophrenic and psychotic bipolar disorder patients and also investigated the relationships between psychotic symptoms and cognitive impairments. Forty-four patients with chronic schizophrenia and 13 with psychotic bipolar disorder underwent a neurocognitive battery which measured performance on key cognitive domains for schizophrenia. Overall intelligence and clinical characteristics were also evaluated. The results revealed that schizophrenic patients performed significantly worse than patients with psychotic bipolar disorder with regard to processing speed, attention/vigilance, and verbal learning domains. Additionally, medium-sized effects were found across all cognitive measures between the two patient groups. However, these differences disappeared after controlling for the severity of psychotic symptoms. A subsequent multivariate analysis revealed that the main effect for group on cognitive performance was insignificant and that psychotic symptoms, especially disorganized symptoms, significantly contributed to cognitive impairment, even after controlling for group differences. This indicated that psychotic symptoms contribute to cognitive impairment in both schizophrenia and bipolar disorder. However, because the patterns of correlations between psychotic symptoms and cognitive performance varied with respect to schizophrenia and psychotic bipolar disorder, it is reasonable to suggest that the underlying mechanisms of these two psychiatric disorders may differ.
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