A measure of planning and impulse control, the delay-discounting (DD) task estimates the extent to which an individual decreases the perceived value of a reward as the reward is delayed. We examined cross-disorder performance between healthy controls (n = 88), individuals with bipolar disorder (n = 23), major depressive disorder (n = 43), and primary psychotic disorders (schizophrenia and schizoaffective disorder; n = 51) on the DD task (using a $10 delayed larger reward), as well as the interaction of DD scores with other symptom domains (cognition, psychosis, and affect). We found that individuals with schizophrenia and schizoaffective disorder display significantly greater rates of discounting compared to healthy controls, while individuals with a primary mood disorder do not differ from healthy controls after adjustment for IQ. Further, impairment in working memory is associated with higher discounting rates among individuals with schizophrenia and schizoaffective disorder, but cognitive dysfunction alone does not account for the extent of impairment in DD. Taken together, these results suggest an impaired ability to plan for the future and make adaptive decisions that are specific to individuals with psychotic disorders, and likely related to adverse functional outcomes. More generally, this work demonstrates the presence of variation in impulsivity across major psychiatric illnesses, supporting the use of a trans-diagnostic perspective.

延迟折扣（DD）任务是对计划和冲动控制的一种度量，它估计随着奖励被延迟，个人降低奖励的感知价值的程度。我们检查了健康对照者（n  = 88），患有双相情感障碍的个体（n  = 23），重度抑郁症（n  = 43）和原发性精神病性疾病（精神分裂症和精神分裂性情感障碍；n = 51）上的DD任务（使用10美元的延迟较大奖励），以及DD评分与其他症状域（认知，精神病和情感）的相互作用。我们发现，与健康对照相比，精神分裂症和精神分裂症患者的折现率显着更高，而在调整智商后，原发性情绪障碍的患者与健康对照没有差异。此外，工作记忆障碍与精神分裂症和精神分裂症患者的折现率较高相关，但仅认知功能障碍并不能说明DD障碍的程度。综上所述，这些结果表明，针对未来进行规划并做出针对精神病患者的适应性决策的能力受损，并可能与不良的功能结局有关。更广泛地说，这项工作证明了主要精神疾病之间冲动存在差异，从而支持了跨诊断观点的使用。