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Pretreatment predictors of cognitive deficits in early psychosis

Published online by Cambridge University Press:  09 October 2007

C. González-Blanch ,
B. Crespo-Facorro ,
M. Álvarez-Jiménez ,
J. M. Rodríguez-Sánchez ,
J. M. Pelayo-Terán ,
R. Pérez-Iglesias  and
J. L. Vázquez-Barquero
C. González-Blanch*
Affiliation:
University Hospital ‘Marqués de Valdecilla’, Psychiatry Research Unit of Cantabria, Department of Psychiatry, School of Medicine, Santander, Spain
B. Crespo-Facorro
Affiliation:
University Hospital ‘Marqués de Valdecilla’, Psychiatry Research Unit of Cantabria, Department of Psychiatry, School of Medicine, Santander, Spain
M. Álvarez-Jiménez
Affiliation:
University Hospital ‘Marqués de Valdecilla’, Psychiatry Research Unit of Cantabria, Department of Psychiatry, School of Medicine, Santander, Spain ORYGEN Research Centre, Melbourne, Australia
J. M. Rodríguez-Sánchez
Affiliation:
University Hospital ‘Marqués de Valdecilla’, Psychiatry Research Unit of Cantabria, Department of Psychiatry, School of Medicine, Santander, Spain
J. M. Pelayo-Terán
Affiliation:
University Hospital ‘Marqués de Valdecilla’, Psychiatry Research Unit of Cantabria, Department of Psychiatry, School of Medicine, Santander, Spain
R. Pérez-Iglesias
Affiliation:
University Hospital ‘Marqués de Valdecilla’, Psychiatry Research Unit of Cantabria, Department of Psychiatry, School of Medicine, Santander, Spain
J. L. Vázquez-Barquero
Affiliation:
University Hospital ‘Marqués de Valdecilla’, Psychiatry Research Unit of Cantabria, Department of Psychiatry, School of Medicine, Santander, Spain
*
*Address for correspondence: Dr C. González-Blanch, Hospital Universitario ‘Marqués de Valdecilla’, Unidad de Investigación en Psiquiatría de Cantabria, Planta 2a, Edificio 2 de Noviembre, Avda Valdecilla s/n, 39008 Santander, Spain. (Email: [email protected])
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Abstract

Background

Predicting cognitive deficits in early psychosis may well be crucial to identify those individuals most in need of receiving intensive intervention. As yet, however, the identification of potential pretreatment predictors for cognitive performance has been hampered by inconsistent findings across studies. We aimed to examine the associations of functional and clinical pretreatment variables with cognitive functioning after a first psychotic episode.

Method

One hundred and thirty-one patients experiencing first-episode psychosis were assessed for psychopathology, pre-morbid functioning, duration of illness, age of onset, and family history of psychosis and neurocognitive functioning. Multiple regression analyses were conducted for six basic cognitive dimensions known to be affected in this population: verbal learning, verbal memory, verbal comprehensive abilities, executive functioning, motor dexterity and sustained attention.

Results

Pre-morbid functioning was the main predictor for five out of the six basic cognitive domains. Pre-morbid social adjustment difficulties were associated with worse performance in executive functioning, motor dexterity and sustained attention. Academic functioning was associated with verbal comprehension, and verbal learning and memory. Gender, age of onset, duration of untreated psychosis, and family history of psychosis had no or limited value as predictors of neurocognitive outcome.

Conclusions

Poor pre-morbid functioning was related to a worse performance in the six basic cognitive dimensions evaluated; however, this accounted for only a small amount of the explained variance. Cognitive impairment is a prominent feature in patients with early psychosis regardless of favorable prognostic features such as short duration of illness, female gender, later age of onset, and non-family history of psychosis.

Keywords

Duration of illnessfirst-episodegenderpredictorspre-morbid functioningschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 5 , May 2008 , pp. 737 - 746
Copyright
Copyright © Cambridge University Press 2007

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