Cognitive and clinical predictors of functional capacity in patients with first episode schizophrenia

Lone Vesterager; Torben Ø Christensen; Birthe B Olsen; Gertrud Krarup; Marianne Melau; Hysse B Forchhammer; Merete Nordentoft

doi:10.1016/j.schres.2012.08.023

Cognitive and clinical predictors of functional capacity in patients with first episode schizophrenia

Lone Vesterager, Torben Ø Christensen, Birthe B Olsen, Gertrud Krarup, Marianne Melau, Hysse B Forchhammer, Merete Nordentoft

65 Citations (Scopus)

Abstract

Background: The predictors of functional capacity in first episode schizophrenia among seven separable cognitive domains and clinical variables are unknown. Aim: To investigate predictors of functional capacity in first episode schizophrenia and the associations between functional capacity and measures of real-world functioning. Methods: Socio-demographic, clinical, and cognitive measures from a sample of patients with first episode schizophrenia spectrum disorders aged 18-34. years (N. =. 117) were examined at baseline, 4-month follow-up, and 10-month follow-up and used to predict concurrent and longitudinal functional capacity. Symptoms were assessed with the Positive and Negative Syndrome Scale, cognitive functioning with the MATRICS Cognitive Consensus Battery, and functional capacity with the brief version of the University of California San Diego Performance-based Skills Assessment. Linear and logistic regression analyses were adjusted for age, gender, and site. Results: Working memory, negative symptoms, and social cognition accounted for 41% of the variance in functional capacity at baseline. Longitudinally, verbal learning, working memory, and negative symptoms predicted 4-month functional capacity. Working memory and visual learning predicted 10-month functional capacity. Functional capacity was associated to global functioning in the univariate analysis, but in multivariable analyses global functioning, financial independence, and independent living were predicted by negative symptoms or general symptoms explaining 15-23% of the variance. Conclusions: The strongest single predictor of functional capacity is working memory, followed by negative symptoms. Clinical symptoms, but not functional capacity, predicted real-world functioning. The usability of the UPSA-B in first episode schizophrenia is discussed. Neurocom, ClinicalTrials.gov Identifier: NCT00472862, http://clinicaltrials.gov/ct2/show/NCT00472862?term=neurocom&rank=1.

Original language	English
Journal	Schizophrenia Research
Volume	141
Issue number	2-3
Pages (from-to)	251-6
Number of pages	6
ISSN	0920-9964
DOIs	https://doi.org/10.1016/j.schres.2012.08.023
Publication status	Published - Nov 2012

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title = "Cognitive and clinical predictors of functional capacity in patients with first episode schizophrenia",

abstract = "Background: The predictors of functional capacity in first episode schizophrenia among seven separable cognitive domains and clinical variables are unknown. Aim: To investigate predictors of functional capacity in first episode schizophrenia and the associations between functional capacity and measures of real-world functioning. Methods: Socio-demographic, clinical, and cognitive measures from a sample of patients with first episode schizophrenia spectrum disorders aged 18-34. years (N. =. 117) were examined at baseline, 4-month follow-up, and 10-month follow-up and used to predict concurrent and longitudinal functional capacity. Symptoms were assessed with the Positive and Negative Syndrome Scale, cognitive functioning with the MATRICS Cognitive Consensus Battery, and functional capacity with the brief version of the University of California San Diego Performance-based Skills Assessment. Linear and logistic regression analyses were adjusted for age, gender, and site. Results: Working memory, negative symptoms, and social cognition accounted for 41% of the variance in functional capacity at baseline. Longitudinally, verbal learning, working memory, and negative symptoms predicted 4-month functional capacity. Working memory and visual learning predicted 10-month functional capacity. Functional capacity was associated to global functioning in the univariate analysis, but in multivariable analyses global functioning, financial independence, and independent living were predicted by negative symptoms or general symptoms explaining 15-23% of the variance. Conclusions: The strongest single predictor of functional capacity is working memory, followed by negative symptoms. Clinical symptoms, but not functional capacity, predicted real-world functioning. The usability of the UPSA-B in first episode schizophrenia is discussed. Neurocom, ClinicalTrials.gov Identifier: NCT00472862, http://clinicaltrials.gov/ct2/show/NCT00472862?term=neurocom&rank=1.",

author = "Lone Vesterager and Christensen, {Torben {\O}} and Olsen, {Birthe B} and Gertrud Krarup and Marianne Melau and Forchhammer, {Hysse B} and Merete Nordentoft",

year = "2012",

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doi = "10.1016/j.schres.2012.08.023",

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T1 - Cognitive and clinical predictors of functional capacity in patients with first episode schizophrenia

AU - Vesterager, Lone

AU - Christensen, Torben Ø

AU - Olsen, Birthe B

AU - Krarup, Gertrud

AU - Melau, Marianne

AU - Forchhammer, Hysse B

AU - Nordentoft, Merete

PY - 2012/11

Y1 - 2012/11

N2 - Background: The predictors of functional capacity in first episode schizophrenia among seven separable cognitive domains and clinical variables are unknown. Aim: To investigate predictors of functional capacity in first episode schizophrenia and the associations between functional capacity and measures of real-world functioning. Methods: Socio-demographic, clinical, and cognitive measures from a sample of patients with first episode schizophrenia spectrum disorders aged 18-34. years (N. =. 117) were examined at baseline, 4-month follow-up, and 10-month follow-up and used to predict concurrent and longitudinal functional capacity. Symptoms were assessed with the Positive and Negative Syndrome Scale, cognitive functioning with the MATRICS Cognitive Consensus Battery, and functional capacity with the brief version of the University of California San Diego Performance-based Skills Assessment. Linear and logistic regression analyses were adjusted for age, gender, and site. Results: Working memory, negative symptoms, and social cognition accounted for 41% of the variance in functional capacity at baseline. Longitudinally, verbal learning, working memory, and negative symptoms predicted 4-month functional capacity. Working memory and visual learning predicted 10-month functional capacity. Functional capacity was associated to global functioning in the univariate analysis, but in multivariable analyses global functioning, financial independence, and independent living were predicted by negative symptoms or general symptoms explaining 15-23% of the variance. Conclusions: The strongest single predictor of functional capacity is working memory, followed by negative symptoms. Clinical symptoms, but not functional capacity, predicted real-world functioning. The usability of the UPSA-B in first episode schizophrenia is discussed. Neurocom, ClinicalTrials.gov Identifier: NCT00472862, http://clinicaltrials.gov/ct2/show/NCT00472862?term=neurocom&rank=1.

AB - Background: The predictors of functional capacity in first episode schizophrenia among seven separable cognitive domains and clinical variables are unknown. Aim: To investigate predictors of functional capacity in first episode schizophrenia and the associations between functional capacity and measures of real-world functioning. Methods: Socio-demographic, clinical, and cognitive measures from a sample of patients with first episode schizophrenia spectrum disorders aged 18-34. years (N. =. 117) were examined at baseline, 4-month follow-up, and 10-month follow-up and used to predict concurrent and longitudinal functional capacity. Symptoms were assessed with the Positive and Negative Syndrome Scale, cognitive functioning with the MATRICS Cognitive Consensus Battery, and functional capacity with the brief version of the University of California San Diego Performance-based Skills Assessment. Linear and logistic regression analyses were adjusted for age, gender, and site. Results: Working memory, negative symptoms, and social cognition accounted for 41% of the variance in functional capacity at baseline. Longitudinally, verbal learning, working memory, and negative symptoms predicted 4-month functional capacity. Working memory and visual learning predicted 10-month functional capacity. Functional capacity was associated to global functioning in the univariate analysis, but in multivariable analyses global functioning, financial independence, and independent living were predicted by negative symptoms or general symptoms explaining 15-23% of the variance. Conclusions: The strongest single predictor of functional capacity is working memory, followed by negative symptoms. Clinical symptoms, but not functional capacity, predicted real-world functioning. The usability of the UPSA-B in first episode schizophrenia is discussed. Neurocom, ClinicalTrials.gov Identifier: NCT00472862, http://clinicaltrials.gov/ct2/show/NCT00472862?term=neurocom&rank=1.

U2 - 10.1016/j.schres.2012.08.023

DO - 10.1016/j.schres.2012.08.023

M3 - Journal article

C2 - 23017825

SN - 0920-9964

VL - 141

SP - 251

EP - 256

JO - Schizophrenia Research

JF - Schizophrenia Research

IS - 2-3

ER -

Cognitive and clinical predictors of functional capacity in patients with first episode schizophrenia

Abstract

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