The course of neurocognitive functioning in first-episode psychosis and its relation to premorbid adjustment, duration of untreated psychosis, and relapse

TY - JOUR

T1 - The course of neurocognitive functioning in first-episode psychosis and its relation to premorbid adjustment, duration of untreated psychosis, and relapse

AU - Rund, Bjørn Rishovd

AU - Melle, Ingrid

AU - Friis, Svein

AU - Johannessen, Jan Olav

AU - Larsen, Tor K

AU - Midbøe, Liv Jaeger

AU - Opjordsmoen, Stein

AU - Simonsen, Erik

AU - Vaglum, Per

AU - McGlashan, Thomas

PY - 2007

Y1 - 2007

N2 - The aim was to determine the post-onset longitudinal course of cognitive functioning in first-episode psychoses and to examine how premorbid adjustment, duration of untreated psychosis (DUP), and clinical variables such as relapse are associated with that course. Consecutive patients with a DSM-IV diagnosis of non-organic psychosis coming to their first treatment in the health care areas under study were included. Ultimately, 207 patients were assessed neuropsychologically at baseline, 138 were reassessed one year later, and 111 two years later. Five dimensions were identified through principal component analysis of eight neuropsychological (NP) test results: Working Memory (WM), Executive Function (EF), Verbal Learning (VL), Impulsivity (Im), and Motor Speed (MS). No major changes were found in the level of neurocognitive functioning from baseline to the 1-year and 2-year follow-ups. Patients with good initial levels of premorbid academic functioning had consistently better scores on WM at all three time points. No association was found between DUP and the longitudinal course of neurocognitive function. Significant associations occurred between better WM and VL at 1 and 2 years and fewer relapses during the first year, but not the second. Most NP deficits are in place by onset of psychosis and are stable over two years. Milder WM deficits are associated with higher premorbid academic functioning. More severe deficits in WM and VL are associated with more relapses during the first year. It is unclear whether NP deficits cause relapse, relapse causes NP deficits, or both are manifestations of a third deteriorative process.

AB - The aim was to determine the post-onset longitudinal course of cognitive functioning in first-episode psychoses and to examine how premorbid adjustment, duration of untreated psychosis (DUP), and clinical variables such as relapse are associated with that course. Consecutive patients with a DSM-IV diagnosis of non-organic psychosis coming to their first treatment in the health care areas under study were included. Ultimately, 207 patients were assessed neuropsychologically at baseline, 138 were reassessed one year later, and 111 two years later. Five dimensions were identified through principal component analysis of eight neuropsychological (NP) test results: Working Memory (WM), Executive Function (EF), Verbal Learning (VL), Impulsivity (Im), and Motor Speed (MS). No major changes were found in the level of neurocognitive functioning from baseline to the 1-year and 2-year follow-ups. Patients with good initial levels of premorbid academic functioning had consistently better scores on WM at all three time points. No association was found between DUP and the longitudinal course of neurocognitive function. Significant associations occurred between better WM and VL at 1 and 2 years and fewer relapses during the first year, but not the second. Most NP deficits are in place by onset of psychosis and are stable over two years. Milder WM deficits are associated with higher premorbid academic functioning. More severe deficits in WM and VL are associated with more relapses during the first year. It is unclear whether NP deficits cause relapse, relapse causes NP deficits, or both are manifestations of a third deteriorative process.

KW - Adolescent

KW - Adult

KW - Brain

KW - Cognition Disorders

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Neuropsychological Tests

KW - Psychotic Disorders

KW - Recurrence

KW - Reproducibility of Results

KW - Social Adjustment

KW - Trail Making Test

KW - Verbal Learning

KW - Vocabulary

U2 - 10.1016/j.schres.2006.11.030

DO - 10.1016/j.schres.2006.11.030

M3 - Journal article

C2 - 17258891

SN - 0920-9964

VL - 91

SP - 132

EP - 140

JO - Schizophrenia Research

JF - Schizophrenia Research

IS - 1-3

ER -