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David Baxter

Mar 26, 2004
Schizophrenia patients make poor decisions in ambiguous situations
By Liam Davenport
21 August 2007
Psychiatry Res 2007; 152: 113?120

Schizophrenia patients find it easy to make choices when their options are clear, but have difficulty when their situation is ambiguous or uncertain, South Korean study findings indicate.

The decision-making ability of patients with schizophrenia has been examined recently using the Iowa Gambling Task (IGT). However, Yang-Tae Kim, from Kyungpook National University in Daegu, and colleagues point out that such investigations only assess emotional decision-making.

Noting that decision-making is based on both cognitive and emotional functions, the team administered the IGT and the Game of Dice Task (GDT), a decision-making task with explicit rules for gains and losses, to 23 patients with stable schizophrenia and 28 healthy controls.

To examine whether poor performances on the IGT in the schizophrenia group were due to impairments in reversal learning, the team also used the Simple Reversal Learning Task (SRLT), which measures the deficit of reversal learning following ventromedial prefrontal cortex damage. In addition, the participants were administered the Wisconsin Card Sorting Test (WCST).

Patients with schizophrenia performed poorly on the IGT in comparison with controls, but the mean GDT scores were similar for the two groups, the team reports in the journal Psychiatry Research.

Further data indicated that, although schizophrenia patients performed worse on the SRLT than controls, there was no association with performance on the IGT. This, the team says, suggests that patients with schizophrenia have impaired emotional decision-making, but normal cognitive decision-making. Schizophrenia patients also performed worse on the WCST than controls but, again, the results were not linked to those obtained with the IGT.

The researchers say: ?This study provides further evidence that emotional and cognitive decision-making are different processes, that schizophrenic patients have difficulty in making decisions under ambiguous and uncertain situations, and that impairments in reversal learning do not contribute to poor performance on the IGT within schizophrenia.?


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