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Executive Control Function in Psychiatric and Medical Illness

SCHILLERSTROM, JASON E., MD

Journal of Psychiatric Practice®: May 2002 - Volume 8 - Issue 3 - p 160-169
WINNER OF RESIDENT PAPER AWARD 2001–2002
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Executive Control Function (ECF) is the ability to plan, sequence, and monitor one’s behavior in order to accomplish a given goal while simultaneously exercising cognitive flexibility to adapt to changing task requirements. Multiple studies demonstrate that ECF predicts functional outcome, level of care required, and work potential for both well and ill populations. However, clinicians often do not routinely assess ECF during mental status evaluations because of the perceived lack of practical bedside tests. This review article discusses the major neuropsychological measures used to probe for impairment, with special emphasis on those that are easily administered at the patient’s bedside. The current literature on executive dysfunction in psychiatric and medical illness is reviewed. The neuroanatomy and neurochemistry of ECF is also reviewed, with emphasis on structural dysfunction in specific illnesses. Finally, various treatment options, both pharmacological and psychotherapeutic, are discussed.

SCHILLERSTROM: Resident Physician, University of Texas Health Science Center at San Antonio.

Please send correspondence and reprint requests to: Jason E. Schillerstrom, MD, The University of Texas Health Science Center at San Antonio, Department of Psychiatry, 7703 Floyd Curl Dr, San Antonio, TX 78284.

Copyright © 2002 Wolters Kluwer Health, Inc. All rights reserved.