Cognitive Predictors of Social and Occupational Functioning in Early Psychosis: A Systematic Review and Meta-analysis of Cross-Sectional and Longitudinal Data

Cowman, Megan; Holleran, Laurena; Lonergan, Edgar; O’Connor, Karen; Birchwood, Max; Donohoe, Gary

doi:10.1093/schbul/sbab033

Cited by 86 publications

(65 citation statements)

References 67 publications

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“…The specificity of the negative effect of risperidone/paliperidone to learning and memory is notable given that impairment in this cognitive domain is particularly severe at the first-episode (3), is associated with poor community/vocational and social functioning (12), and shows decline in longitudinal studies (although not always in the verbal domain) (6, 7). While the cognitive effects of medication cannot be accurately determined in naturalistic longitudinal cohort studies since cumulative antipsychotic exposure is confounded with the effect of severity of illness, the current findings suggest antipsychotic medication (in this case, risperidone/paliperidone) may contribute to the decline in learning/memory observed in these studies.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Thus, the effect of antipsychotic medication on cognitive functioning cannot be disentangled from the illness itself. As cognitive functioning is one of the most robust predictors of functional recovery following early psychosis (12, 13), it is critical to understand the effects of antipsychotics on cognitive functions.…”

Section: Introductionmentioning

confidence: 99%

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Antipsychotic Effects on Longitudinal Cognitive Functioning in First-Episode Psychosis: A randomised, triple-blind, placebo-controlled study

Allott

Yuen

Baldwin

et al. 2022

Preprint

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Objective: Cognitive impairment occurs in antipsychotic-naive first-episode psychosis (FEP), but antipsychotics confound interpretation of the longitudinal course of cognition. The primary aim was to disentangle the effects of illness from antipsychotics on cognition over the first 6-months of FEP treatment. Methods: Randomised, triple-blind placebo-controlled trial (Staged Treatment and Acceptability Guidelines in Early Psychosis; STAGES), where cognition was a secondary outcome. Antipsychotic-naive FEP patients were allocated to receive risperidone/paliperidone (N=38) or placebo (N=40) in addition to intensive psychosocial therapy for 6-months. A healthy control group (N=42) was also recruited. A cognitive battery assessing attention, working memory, processing speed, verbal fluency, cognitive control and verbal paired-associate learning and memory was administered at baseline and 6-months. Twelve- and 24-month follow-up was also conducted. Results: Over the 6-month trial period, cognitive performance remained stable (working memory, verbal fluency) or improved (attention, processing speed, cognitive control), with no group-by-time interaction evident. The exception was for verbal paired-associate learning and memory, where a significant group-by-time interaction was observed. The placebo and healthy control groups improved, and the medication group deteriorated on immediate paired-associate recall (p=0.039) and delayed cued recall (p=0.005); effect sizes were medium-to-large. Findings were similar when only trial completers were included in the analysis. Conclusions: Risperidone/paliperidone may cause progression of memory impairment in the early months of FEP. Replication is needed in confirmatory trials. The findings support the need for careful consideration of the risks and benefits of various antipsychotics and the importance of accounting for their cognitive effects in longitudinal research.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Antipsychotic Effects on Longitudinal Cognitive Functioning in First-Episode Psychosis: A randomised, triple-blind, placebo-controlled study

Allott

Yuen

Baldwin

et al. 2022

Preprint

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“…This supports our previous findings that during the pandemic restrictions people with bipolar disorder were more likely to use the Internet a lot for their daily activities compared to people with psychosis 16 . Cognitive and occupational disfunctions that are common in schizophrenia 38 might not facilitate development of digital skills. It might also be that specific SMIrelated barriers to digital engagement (e.g.…”

Section: Discussionmentioning

confidence: 99%

Measuring the digital divide among people with Severe Mental Ill Health using the Essential Digital Skills framework

Spanakis

Wadman

Walker

et al. 2021

Preprint

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Aims: Amidst the vast digitalisation of health and other services during the pandemic, people with no digital skills are at risk for digital exclusion. This risk might not abide by the end of the pandemic. This paper seeks to understand whether people with severe mental ill health (SMI) have the necessary digital skills to adapt to these changes and avoid digital exclusion. Methods: 249 adults with SMI across England completed a survey online or offline. They provided information on their digital skills based on the Essential Digital Skills (EDS) framework, sociodemographic information, and digital access. This is the first time the EDS is benchmarked in people with SMI. Results: 42.2% had no Foundation Skills and 46.2% lacked skills for daily life (lacking Foundation or Life Skills). 23.0% of those working lacked skills for professional life (lacking Foundation or Work Skills). The most commonly missing skills were handling passwords and using the device settings (Foundation Skills) and online problem solving (Skills for Life). People were interested in learning more about approximately half of the skills they did not have. People were more likely to lack Foundation Skills if they were older, not in employment, had a psychosis-spectrum disorder, or had no Internet access at home. Conclusion: A significant portion of people with SMI lacked Foundation Skills in this objective and benchmarked survey. This points to a high risk for digital exclusion and the need for focused policy and tailored health sector support, to ensure people retain access to key services and develop digital skills and confidence. To our knowledge this is the first time this has been described using the Essential Digital Skills (EDS) framework. Services, including the NHS, need to be aware and mitigate the risks.

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“…Cognitive function has attracted attention in the public health field in recent years [1][2][3][4]. Cognitive impairments have been assessed subjectively and objectively.…”

Section: Introductionmentioning

confidence: 99%

Associations of Cognitive Complaints and Depressive Symptoms with Health-Related Quality of Life and Perceived Overall Health in Japanese Adult Volunteers

Toyoshima

Inoue

Baba

et al. 2021

IJERPH

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Cognitive complaints, defined as perceived cognitive dysfunction in daily living, are associated with depressive symptoms. The associations of cognitive complaints and depressive symptoms with health-related quality of life (HRQoL) and perceived overall health in Japanese adults remains unknown. To investigate these relationships, we evaluated a convenience sample of 525 Japanese adult volunteers (Mage: 41.3 ± 11.7; 238 male and 287 female). We used the Cognitive Complaints in Bipolar Disorder Rating Assessment (evaluating cognitive complaints), Patient Health Questionnaire-9 (evaluating depressive symptoms), EuroQol-5 Dimension-5 Level (EQ-5D-5L; evaluating HRQoL), and EuroQol-Visual Analogue Scale (EQ-VAS; evaluating perceived overall health). Our path analyses suggested that both cognitive complaints and depressive symptoms had significant total effects on HRQoL and perceived overall health. Furthermore, cognitive complaints were not significantly associated directly with HRQoL and perceived overall health, whereas cognitive complaints were significantly associated with HRQoL and perceived overall health indirectly via depressive symptoms. Depressive symptoms were significantly associated directly with HRQoL and perceived overall health. This study suggests that depressive symptoms may mediate the associations of cognitive complaints with HRQoL and perceived overall health. Thus, to address the HRQoL and perceived overall health associated with cognitive complaints, evaluation and intervention for depressive symptoms may be useful in public health.

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Cognitive Predictors of Social and Occupational Functioning in Early Psychosis: A Systematic Review and Meta-analysis of Cross-Sectional and Longitudinal Data

Cited by 86 publications

References 67 publications

Antipsychotic Effects on Longitudinal Cognitive Functioning in First-Episode Psychosis: A randomised, triple-blind, placebo-controlled study

Antipsychotic Effects on Longitudinal Cognitive Functioning in First-Episode Psychosis: A randomised, triple-blind, placebo-controlled study

Measuring the digital divide among people with Severe Mental Ill Health using the Essential Digital Skills framework

Associations of Cognitive Complaints and Depressive Symptoms with Health-Related Quality of Life and Perceived Overall Health in Japanese Adult Volunteers

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