Although cognitive deficits are recognized as a core feature in schizophrenia, their evolution over the course of the illness is still debated. Longitudinal studies of cognition in patients after a first episode of psychosis (FEP) provide extremely useful information, in that they include an adequate and realistic baseline measure of cognitive performance, while at the same time minimizing the effect of confounding variables associated with chronicity. The aim of this systematic review was to summarize findings of studies assessing the longitudinal course of neuropsychological deficits in patients with FEP for durations of at least one year. Overall, the neuropsychological deficits that are present following a first episode of psychosis appeared to remain stable over time for periods of up to ten years, the only possible exception being verbal memory deficits, where there is some evidence of further deterioration over the long term. However, further studies are needed to confirm this conclusion, especially in the (somewhat inconsistently defined) domain of executive function. Improvements in psychopathology appear to positively influence the course of cognitive deficits, although the effects of antipsychotic medication are not as clear.

The diagnosis of "mental illness" is accompanied by negative implications regarding a person's competence. Self- and other-descriptions about the "patient" are embedded within broader cultural and societal discourses, influencing his/her relationships. The parental role seems to be one of the most sensitive, especially for women. Mothers hospitalized in psychiatric units often have to separate themselves from their children either temporarily, during hospitalization, or permanently, after a loss of custody. However, many studies have shown that mothering remains important for them. We interviewed 20 women, inpatients on a psychiatric unit and mothers of 3.5-18-year-old children, recording their narratives about their children and exploring their thoughts and understanding of the concepts of motherhood and mental illness. We also explored the way in which the mother-child dyad interacted with the family and its social context. Most mothers had a consistent and coherent narrative about their children and they had certain expectations of them. The mother-child bond was strong, even when the children had been removed from their mothers' custody. However, mothers were facing great difficulties with their partner and with the broader family context. Also, the social discourses regarding mental illness, (e.g., violence and incapability for mothering), were extremely oppressive for these women. They felt that they were the victims of societal attitudes even before they became pregnant. These findings suggest the importance of listening to the voices of these women; acknowledging their competence in the therapeutic context; involving them with their families, and in legal and social contexts; and in planning supportive programs for them.

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The cumulative vascular burden resulting from chronic accumulation of lacunar infarcts within the thalamus, basal ganglia, and deep white matter may be more important than single infarcts in the prediction of PSD.